Dongbo Fu

1. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20161 |
mCessation and its role in
national tobacco cessation
and treatment system
Dongbo Fu
Tobacco Free Initiative
World Health Organization

2. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20162 |
Outline
 What is mCessation?
 What are key components of a national
tobacco cessation and treatment system?
 How mCessation can be used to strengthen
national tobacco cessation and treatment
system?

3. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20163 |
What is Mobile
cessation
(mCessation)?

4. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20164 |
mCessation
 Tobacco cessation interventions
delivered by mobile phones
– Mainly for tobacco users who want to
quit
– Mainly via mobile text messaging

5. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20165 |
mCessation
 Started as adjuncts to quit lines and
Internet quit coaches
– New Zealand Quitline 'Txt2quit' programme
– UK NHS Stop Smoking Service's 'Together'
programme
– U.S. National Cancer Institute's smokefree TXT
programme
 Standalone programme:
– Costa Rica, Tunisia, India, the Philippines
Source: Whittaker R, et al. Mobile phone based interventions for smoking cessation, Cochrane Review 2012

6. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20166 |
Evidence
Smartphone
applications
Mobile phone-based +
Internet-based
Mobile phone-based
• There are no
published
studies on
smartphone
applications
designed to
help people
stop smoking
• A combined internet-
mobile phone
programme is
effective up to 12
months (RR 2.03,
95% CI 1.40 to 2.94)
• Combined evidence
from 12 studies
• 6 month quit rate
compared with control
group (RR 1.67, 95%
CI 1.46 to 1.90, over
11,000 participants)
Sources: 1. Cochrane review Whittaker 2016 2. Cochrane review Whittaker 2009
● Efficacy

7. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20167 |
Evidence
One analysis of txt2stop, a UK-based intervention,
indicates that it was cost-effective
• Cost per quitter for
telephone counselling:
£895
• Cost per quitter: £278
• Gain: 0.3 life years per
quitter; or 0.5 quality
adjusted life years per
quitter
Source: Guerriero 2012
● Cost-effectiveness

8. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20168 |
What are key
components of a
national tobacco
cessation and
treatment system?

9. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 20169 |
The WHO FCTC Article 14
guidelines recommend that
all Parties should aim to
develop a comprehensive
tobacco cessation and
treatment system
What support we should offer tobacco
users to quit?

10. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201610 |
key components of a treatment system
recommended by Article 14 guidelines
 Population-level approaches
– Mass communication
– Brief advice
– Quit lines
 Intensive individual approaches
– Specialized tobacco dependence treatment
 Medications
 Novel approaches and media
– Cellphone text messaging

11. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201611 |
How mCessation
can be used to
strengthen national
tobacco cessation
and treatment
system?

12. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201612 |
Evaluating the impact of tobacco cessation
programmes
(Reach x Efficacy) x (Adoption x
Implementation x Maintenance) = Impact
Source: Glasgow, RE, Vogt, TM, Boles, SM. Evaluating the public health impact of health promotion
interventions: The RE-AIM framework. Am J Public Health 1999;89(9):1322–1327.

13. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201613 |
Source: WHO report on the global tobacco epidemic, 2015
 24 countries
provide
comprehensive
tobacco
dependence
treatment
 97 countries
providing tobacco
cessation support
in most or some
PHC facilities, and
fully or partially
cost-covered
 61 countries
provide national
toll-free tobacco
quit line services
The reach of cessation programmes is low

14. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201614 |
mCessation has the potential to reach a large
number of tobacco users
 Mobile phones are a new
channel for individualized
information to be delivered
inexpensively wherever the
person is located:
– Worldwide: mobile cellular subscriptions
will reach almost 7 billion (a penetration
rate of 96%) by end of 2014.
– In developing countries: mobile-cellular
penetration will reach 90% by end 2014;
the number of mobile cellular
subscriptions will account for 78% of the
world’s total.
Source: The World in 2014: ICT Facts and Figures

15. ICO-WHO Symposia on Tobacco Control, Barcelona, 12 December 201615 |
mCessation has the potential to reach a large
number of tobacco users
 The potential benefits of mobile phone-based
smoking cessation interventions:
– The ease of use anywhere at anytime;
– Cos-effective delivery and scalability to large populations
regardless of location
– Reaching vulnerable populations who may be at risk of
smoking and who may have difficulty accessing traditional
cessation services (such as adolescents and young tobacco
users).
Sources: 1.Whittaker R, et al. Mobile phone based interventions for smoking cessation, Cochrane Review
2012; 2. Kong G, et al. Text messaging-based smoking cessation intervention: A narrative review 2014.

16. Thank you for your attention