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Quit Smoking or Die: What Ukraine Offers Smokers

May
On 31 May, the world celebrates World No Tobacco Day. The slogan of the World No Tobacco Day in 2021 is “Commit to Quit”. The event aims to draw public attention to the challenges faced by Ukraine’s 8 million smokers who need help to quit smoking.
In the run-up to the event, the Healthy Initiatives NGO conducted an assessment of accessibility of smoking cessation programs for smokers in Ukraine based on the findings of a representative survey conducted by the Kyiv International Institute of Sociology and on their own research of smokers’ motivation to give up smoking.
“Despite its obligations to the World Hea
lth Organization, Ukraine is ignoring the issue of providing smoking cessation support to smokers and thereby fails to comply with Article 14 of the FCTC”, said Natalia Toropova, the Chairwoman of Healthy Initiatives.

Every day, thousands of smokers try to give up the harmful habit. Nearly one in two (45% of all Ukrainian smokers) have tried to quit in the past year. However, none of them (0% of respondents) have ever received medical advice or assistance when trying to quit.
What are the most popular smoking cessation methods? According to the Healthy Initiatives NGO survey of March 2021, more than 70% of those who tried to quit smoking relied only on their own willpower. And most of them relapse afterwards.
“The effectiveness of independent attempts to give up smoking is estimated at 4-8%, whereas that of stop smoking support programs at 20-40%”, says Dr. Yuriy Stratovych, a high category physician.

Doctors in Ukraine are neither trained nor motivated to provide support to smokers. 62% of cigarette smokers and 66% of HTS users reported that their doctor had never encouraged them to quit smoking (Healthy Initiatives survey, 2021).
Victim Blaming has become a cornerstone of the country’s public health policy. Smokers bear the full responsibility for the fact that they are unable to overcome their addiction on their own. The health care system’s attitude towards smokers is based on the principle “quit smoking or die”.
The resulting low effectiveness of unassisted smoking cessation efforts (without the support of medical programs) has led to a slowdown in smoking prevalence in Ukraine. According to the WHO data, the prevalence of smoking in Ukraine fell from 35% to 25% over the period of 2007-2017. However, in 2020 the smoking prevalence in Ukraine rose to 33.9% among the population aged 18-69 years, which is a high rate for Europe. The rate of smoking reduction has dropped and is now mere 3% of smokers per year, putting off the goal of a complete cessation of the tobacco epidemic in Ukraine for an indefinite period of time.
“Countries where the medical doctors provide the leadership are the countries where we see the fastest decline in adult smoking”, says Derek Yach, President of the Foundation for a Smoke-Free World, who, in his capacity as the Executive Director of WHO’s Noncommunicable Diseases Program, was one of the initiators of the Framework Convention on Tobacco Control. “Ukraine has an extremely high smoking rate by worldwide standards.If the doctors get involved, if they do far more in cessation, and if the government work with doctors to make harm reduction available far more and tackle the disinformation, that high smoking rate among men could come down and many-many lives would be saved.”

Natalia Toropova identified the main factors that would contribute to a rapid reduction in smoking in Ukraine. Firstly, it is necessary to continue raising the prices on conventional cigarettes in accordance with the plan of harmonizing excise duties. In addition, it is essential to address the smuggling of cigarettes from neighboring countries. Nowadays, selling smuggled cigarettes is becoming increasingly profitable in Ukraine because of the price difference.
Secondly, part of the revenues from excise tax on tobacco should be spent on smoker support programs, as well as on anti-tobacco public awareness campaigns. The tobacco cessation hotline should be reopened.
Thirdly, following the example of European countries, we should encourage mass smokers to give up conventional cigarettes, which are the cause of cancer, cardiovascular and other deadly diseases. In particular, putting combustible cigarettes on a par with harm reduction products (e-cigarettes)preserves the tradition of tobacco use and demotivates smokers to abandon smoking harmful cigarettes. In the meantime, the experience of the UK health system demonstrates the effectiveness of harm reduction products for experienced smokers who want to quit smoking. This view is supported by scientific evidence. According to an independent research conducted in the UK in 2020, harm reduction products contribute to smoking cessation in 41% of smokers and prevent smoking relapse in 20% of smokers.
Full video conference: