Tobacco (43) Q1. Do people understand the harms of using tobacco products? (17) How can people be better informed? (2)

7 March, 2023

Thanks to this HIFA forum discussions on tobacco addiction which enables us to hear such interesting experiences and research from our colleagues in various countries.

Most has been said already and I would like to add some new points which could enable inclusion of community participation in policies such as:

1. Education on tobacco addiction should start from a very young age such as adding it in the ‘primary school curriculum’.

e.g. How often do we see little children watching their parents and elders smoking (including outside airport smoke lounges) but are not questioning about the consequences. Some of our colleagues may remember an incident when a child has asked their near ones ‘why do you smoke?’ and the person has left smoking out of embarrassment or at least hides to smoke. Children can often be very powerful in emotionally changing adult behaviours.

2. All health facilities should be encouraged to establish a program with a ‘trained staff’ on tobacco cessation to help not only patients but also their staff.

3. Medical, Nursing and Allied Health Sciences should be encouraged to get ‘formal training’ (tools, online courses) on tobacco cessation during their schooling. This will assist in addressing the scarcity of health care workers in low-and middle- income countries (LMICs) who are already overstretched in providing the essential health care services.

4. Basic Training course (tools) on Tobacco cessation should be made simple and short (standards as per the country) to encourage more patient participation during their hospital stay or in outpatient clinics.

5. ‘Smoking cessation classes’ in centres should be made more accessible to the communities in LMICs, just like how there is a proliferation of gym centres everywhere.

6. ‘Tobacco cessation’ TV screening should be included along with what is shown normally on immunisations, health for maternal and children, while patients are waiting at the out-patient clinic.

7. Health care workers should have access to updated evidence-based information (social media, scientific platforms etc.).

8. All health facilities should be encouraged to advertise that they are a ‘smoke free campus’.

9. Infographics (posters) should be freely (without cost) available to communities particularly in LMICs.

10. Movies should not encourage showing actors smoking unless it is required in the script (very rarely it would be!).

Best wishes

Dr Meena Nathan Cherian, MBBS, MD (Anaesthesia)

(Former WHO Lead Emergency and Essential Surgical Care Program, Geneva, Switzerland).

Director, Global Health New Challenges:online courses, Geneva Foundation for Medical Education & Research (GFMER), Switzerland. <>

Senior Advisor, Global Action, International Society of Geriatric Oncology (SIOG), Switzerland. SIOG Secretariat - SIOG <>

Adjunct Prof.The Chinese University of Hong Kong,Shenzhen,HK China. <>

WHO-HIFA Working Group on Essential Health Services and COVID-19; mHEALTH-INNOVATE. <>

Geneva, Switzerland; <>

HIFA profile: Meena Cherian is Director, Emergency & Surgical Care program, Geneva Foundation of Medical Education and Research, Geneva, Switzerland. She is a member of the HIFA working groups on Essential Health Services and COVID-19, and Learning for quality health services.

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