1 / 29

Global Bridges Latin America Gustavo Zabert MD Regional Director

SRNT preconference: Progress in the development, monitoring, and implementation of tobacco dependence treatment around the world. Global Bridges Latin America Gustavo Zabert MD Regional Director. Gustavo Zabert Disclosure of COI. 19TH ANNUAL INTERNATIONAL MEETING

lorene
Download Presentation

Global Bridges Latin America Gustavo Zabert MD Regional Director

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. SRNT preconference: Progress in the development, monitoring, and implementation of tobacco dependence treatment around the world Global Bridges Latin America Gustavo Zabert MD Regional Director

  2. Gustavo Zabert Disclosure of COI 19TH ANNUAL INTERNATIONAL MEETING March 13th 2013, Boston Mass

  3. Latin America • South of Rio Bravo • Area 21,069,500 km² (7,880,000 sq mi), • 2010 pop 590 million • Languages : Spanish, Portuguese, Quechua, Maya, Guaraní, Aymara, Nahuatl, and others. • Combined GDP at 5.16 trillion (US 6.27 trillion) • 33 countries (CA-Ca-SA)

  4. Smokers in LA TobaccoAtlas 2012

  5. Teens smoking in LA TobaccoAtlas 2012

  6. TobaccoMortalityTobaccoAtlas 2012

  7. TobaccoAtributableMortality in LA

  8. Smoking in Latin America • 1/3 of population smoke (higher among men) • Highest prevalence • Males: Cuba and Chile • Females: Argentina and Chile • Teens: Argentina and Chile • Physicians: Cuba, Argentina and Chile • 2000 tobacco related mortality 265.000 death per year (underestimated)

  9. Tobaccoepidemic in LA 70% 60% 50% 40% 30% 20% 10% 0% Stage II StageIII 40% 30% 20% 10% StageI StageIV Smokers Tobaccodeaths Male deaths Females males Female deaths 0 10 20 30 40 50 60 70 80 90 100 Años López, Collishaw, 1994

  10. SmokingPrevalenceamongDoctors

  11. Scenario may be changed! Smoker physicians: Uruguay % fumadores 35 30 25 20 15 10 5 0 1992 2001 2007 2011 Año 11,1% mujeres 8,2% hombres, Boado M, Bianco E. Rev Urug Cardiol 2011;26:214-24

  12. Scenario may be changed! • *MinerviniMC et al .RAMR 2006(3):100-105 • ** Schotlender J et al ReportAAMR 2012

  13. Accessibility of care Higher level intensive intervention specialized teams Reports Nicotine Dependence Centers Reportedprescription (15-20%) Intermediatelevel (Drugs + IntensiveIntervention) healthcare providers´ surveys should prescribe Acknowledgetoreceive (50%) Basic level brief intervention (5 A ABC) populationsurvey shouldreceive 30% Smokers Population of LatinAmerica 70% consulta

  14. Equity in smoking cessation Howshouldit be? Howis? For smokers highly dependent and co-morbidities Higher level Highereducationand incomes Health coverage Insurance and/or mutualism socioeconomic level Intermediate level Foreverysmokerdependent Health Services housing Work poverty UBN Basic level Foreverysmoker 30% fumante Población de Latinoamérica 70% consulta

  15. Faculty Puebla 2011

  16. Global Bridges Latin America: 2012 Team • LA Regional Director Gustavo Zabert gzabert@gmail.com • LA Regional secretary Vicki Baldi victoriabaldi@gmail.com • LA Host Organization Inter American Heart Foundation (IAHF) • Beatriz Champagne beatriz.champagne@interamericanheart.org • Javier Valenzuela Javier.valenzuela@interamericanheart.org • Faculty team • Carlos Jimenez Ruiz (Spain) Raul Sansores Martinez (Mexico) Alvaro Huarte (Uruguay) • Erika Urdapilleta(Mexico) Eduardo Bianco (Uruguay) Veronica Torres (Uruguay • DanielBuljubacich(Argentina) RogelioPendino (Argentina) Nicolas Flandorffer (Argentina) • Edgardo Sandoya (Uruguay) Victor San Martin (Paraguay) Maribel Fernandez Cristobal (Spain) • Roberto Castro Cordoba (Costa Rica) Fernando Müller (Argentina) Carlos Araujo (Brasil) • Justino Regalado Pineda (Mexico) Andres Mainini(Argentina) Miriam Di Loretto (Argentina) • Javier Saimovici (Argentina) Ernesto Ruiz (Argentina) Eduardo Valeff (Argentina) • Elma Correa (Mexico) Mark Cohen Todd (Guatemala) Elba Esteves (Uruguay) • Roberto Castro (Costa Rica) Fernando Muller (Argentina) Jose Miguel Chatkin (Brasil) • Marcelino de Vega (Argentina) Luis D Larrateguy (Argentina) Carlos Viegas (Brasil)

  17. GLOBAL BRIDGES LA: training sessions

  18. Training in smoking cessation: Real world impact estimation • What would be the impact if each HCP trained offers ONE (1) brief advice (BA) every working day in the year after training? 789 HCP trained X 240 workingdays = 189.360 smokerswouldhadreceived BA 189.360 smokersX 2,5% (abstiencerate) = 4.734 quitters December 3rd, 2012

  19. Training in smoking cessation: Real world impact estimation • What would be the impact if 20% of remaining smokers receive NRT plus intensive intervention (IT) in the following year work? 189.360 smokers – 4.734 quitters = 184.626 smokers 184.626smokers X 20%= 34.210 smokers IT + NRT 36.925 smokers IT + NRT X 12% (abstiencerate)= 4431 quitters December 3rd, 2012

  20. Training in smoking cessation: Real world impact estimation 4734 quitters w/briefadvice + 4.431 quitters w/IT +NRT 9.165 quitters in 2013 December 3rd, 2012

  21. GLOBAL BRIDGES Latin America Training 2011/2012 • Was GB LA training program effective? • Facts: • Behaviour change interventions are typically complex with multiple, potentially interacting, components • Two categories of intervention components • What´s intervention program • How is provided • Behaviour change techniques (BCT) involve competencies (knowledge and skills) • Knowledges are easier to assess

  22. Competence-based training for a national stop smoking service: an English case studyWorld Conference on Tobacco or HealthSingapore, Wednesday 21st March 2012Dr Andy McEwenNCSCT Executive Director

  23. All changes p<0.001 • 5,510 unique trainees registered • 2,289 UK stop smoking practitioners • 1,540 completed both assessments

  24. GLOBAL BRIDGES Latin America Evaluation 2011/2012 Percentage of questions scored correctly among 500 trained

  25. Behaviour change techniques (BCTs) • Describe treatment programme • Build rapport • Describe what behavioural support involves • Facilitate and advise on use of social support • Describe stop smoking medications • Assist smoker to set a quit date • Enhance motivation and self-efficacy • Emphasise the importance of the not-a-puff rule • Secure commitment to the not-a-puff rule • Help smoker cope with barriers, cues and triggers • Review experience of medication usage • Advise on adjustment of medication use • Use CO measurement • Deal with discrepancies between self-report and CO measures • Deal with lapses • Assess commitment, readiness and ability to quit

  26. 719 trainees in 28 courses 21 courses with follow-up data (N=569)

  27. GLOBAL BRIDGES Latin America Evaluation 16 competences 2012 Not confident Mean confident Highly confident 224 trainees in 6 courses 83 with follow-up data

  28. Conclusions

More Related