Nationwide Smoking Cessation Treatment Support Program – Turkey project

• In 2011, Turkish MoH initiated a nation-wide “Smoking Cessation Treatment Support Program” (SCTSP).
• Major interventions were free medication (Varenicline and Bupropion) and primary care support.
• 164,733 participants were recruited in designated smoking cessation clinics.
• The real-life quit rates were comparable to those of clinical evidence to date.
• This success model could be implemented to the public health policy of other countries.

BackgroundIn 2011, Turkish Ministry of Health (MoH) initiated a nation-wide “Smoking Cessation Treatment Support Program” (SCTSP), to provide smoking cessation drugs free of charge.MethodsSCTSP was conducted in all 81 cities of Turkey, at 228 smoking cessation clinics, and by over 400 physicians. In total, 164,733 participants took advantage of the program between January and November 2011. Varenicline (Champix®, Pfizer) and Bupropion (Zyban®, GlaxoSmithKline) were used in the program at a ratio of 0.7 and 0.3 respectively. Post-program data were obtained by phone interviews from randomly selected participants, who had completed a 1-year follow-up after enrollment in the program.FindingsQuit rates were 29.6% for those given Varenicline and 25.1% for those given Bupropion. The quit rates for participants with hypertension (35.0%), diabetes mellitus (36.9%), coronary artery disease (32.1%) and cerebrovascular events (34.0%) were higher than those without. Increased age, female gender, longer duration of cessation drug use, low Fagerstrom score, the presence of hypertension, the absence of chronic obstructive pulmonary disease, and the absence of cancer were found to be associated with higher success rates.InterpretationSCTSP is the first successful report of a nation-wide community-based smoking cessation intervention. The real-life quit rates obtained herein are comparable to those of clinical evidence to date. The centralization of smoking cessation clinics, standardization of treatment guidelines, application of a specific drug assignment algoritm, and provision of primary care support and follow-ups by trained physicians, appeared to be key elements for success.