31 MAY 2011 – A WORLD TREATY THAT SAVES LIVES 

On 31 May of each year, the World Health Organization (WHO) celebrates “World No Tobacco Day“. This year the WHO chose the “Framework Convention on Tobacco Control” as its theme.

This Convention was the first international treaty negotiated under the auspices of the WHO, representing a milestone in the history of public health worldwide. Unanimously approved in May 2003 at the World Health Assembly, it came into force on 27 February 2005 and so far it has been ratified by over 170 Parties.

Portugal is part of this Convention, following its approval by the Government in November 2005 (Decree 25-A/2005, of 8 November).

The Framework Convention was the result of a long process of technical and intergovernmental negotiations based on scientific evidence. This Convention, which reaffirms the right of every human being to enjoy better health, has brought a new legal dimension to international cooperation in the area of prevention and tobacco control.

The 2011 World No Tobacco Day aims to highlight the importance of this Treaty, stressing the obligations of the Parties and of WHO in the context of the Conference of the Parties, as the central body, which has power of deliberation with regard to its implementation.

Tobacco use is one of the leading causes of illness and premature death worldwide. According to WHO, about 6 million people die every year due to tobacco related diseases. This figure might rise to 8 million by 2030 if no effective preventive measures are taken. After having contributed to the deaths of 100 million people in the twentieth century, smoking can lead to the loss of 1000 million lives in the twenty first century.

Like any other treaty, the Framework Convention for Tobacco Control imposes legal obligations to the Parties that have ratified it. These obligations include the following

– To protect public health policies from the commercial interests or any others created by the tobacco industry;
– To take steps related to prices and taxes to reduce demand for tobacco;
– To protect people from exposure to environmental tobacco smoke;
– To regulate the contents of tobacco products;
– To regulate the dissemination of information on tobacco products;
– To regulate the packaging and labelling of tobacco products;
– To inform and educate the population, particularly children, about the dangers of tobacco consumption;
– To ban advertising, promotion and the sponsorship of tobacco;
– To promote smoking cessation and offer help to quit tobacco dependence;
– To fight the illicit trade of tobacco products;
– To prohibit the sale to minors and by minors;
– To support economically viable alternatives to tobacco growing.

NEW WEBSITE FOR DOCTORS AND MEDICAL STUDENTS

One in two smokers dies prematurely and encouragement from a physician is an important motivating factor for patients wanting to stop smoking.* Hughes JR. CA Cancer J Clin 2000; 50: 143-51

With the aim of supporting health professionals in the management of patients seeking to quit smoking on a permanent basis, a pharmaceutical company, in collaboration with several partners, including the Portuguese Society of Pneumology – Tobacco Consumption Committee, the Portuguese Confederation of Tobacco Prevention – COPTT, and the Portuguese Society for Tobacco Studies, launched on 31 May 2011, World No Tobacco Day, the website “5As – 5 steps to stop smoking”.

Aimed exclusively at health professionals and medical students, the www.5as.com.ptprovides online data and medical training on Smoking Cessation, and is an important working tool that aims to improve clinical skills when communicating with patients.

Approach, Advise, Assess, Assist and Accompany are the principles that underlie the creation of this website, where one can find information about the disease (tobacco use and addiction) and how to approach it, and about theoretical and practical aspects – including supporting materials – that will enable health professionals to identify specific needs and improve the quality of life and control of patients.

In order to encourage the sharing of information among health professionals, the www.5as.com.pt (which has distinct names in other countries), has, to date, brought together a group of 15 European specialists who, through the website, may counsel, inform, and offer advice on practical tools and materials that may be used when communicating with smoking patients, allowing it to be more productive and effective in smoking cessation. This group of specialists includes professionals from Portugal (4), Spain (2), United Kingdom (4), France (1), Germany (2), Norway (3) and Sweden (1).

Apart from enabling access to a set of clinical guidelines and medical and scientific information, www.5as.com.pt also allows viewing practical solutions through questions that reflect several common situations and scenarios, and which can be adapted to the circumstances and profile of each individual patient.

With regard to medical students, their registration is possible when supported by a medical graduate.

The Added Responsibility of Medical Schools 

Medical Schools and their corresponding professionals have a determinant role to play in smoking prevention and control in the country.
Although it was not necessary for the law to state it, the truth is that the Portuguese Legislation (Law no. 37/2007 of 14 August) defines some of the measures to be adopted by Medical Schools – through the example given by their professionals, forbidding smoking indoors, making information and health education available to citizens and including the topic of prevention and treatment of the use of, and addition to, tobacco in the syllabus of the undergraduate and postgraduate training of doctors, as they are privileged agents in health education and promotion. The aforementioned law also stipulates the creation of smoking cessation consultations at health institutions, namely health centres, pneumology, cardiology, psychiatry, oncology, and obstetrics services, and in support centres for alcoholics and drug abusers.

In the Faculty of Medicine of the University of Lisbon, it is imperative to continue to inform, educate and teach. Students, lecturers, employees, and governing bodies are called to give their contribution to the provision of more and better health for all.

Luís Rebelo
Coordinator of the General and Family Medicine Unit (Institute of Preventive Medicine)
lrebelo@sapo.pt