Smoking and Smoking Cessation Treatment in Cyprus
By Andri Aristotelous & Peter Hajek
The prevalence of smoking in Cyprus is somewhat lower than in neighbouring countries. Two surveys of smoking prevalence were completed some eight years apart, the first one in 1989 (N=10849) and the second one in 1997 (N=1976). The first of these was a part of a large stratified household survey by the Statistical Office of the Ministry of Finance (Smoking in Cyprus Department of Statistics and Research 1989). The Ministry of Health conducted the second survey on a smaller scale, but used the same methodology and sampling frame (Smoking Prevalence among Cypriot Population, Ministry of Health 1999). Over these eight years, the prevalence of smoking in men seems to have decreased from 43% to 39% while the prevalence of smoking in women remained virtually unchanged (7% and 8%, respectively). The much higher smoking prevalence in men is typical for Southern Europe and Eastern Mediterranean. Interestingly, compared to Western Europe, the age of initiation to smoking is relatively late, 17 years for men and 21 years for women.
The Cyprus Ministry of Health recognizes that comprehensive tobacco control policies need to include smoking cessation. Smoking cessation medications available in Cyprus currently include only the Novartis nicotine patch and gum, but the Ministry is considering other products. Three years ago, Aristotelous initiated a pilot smoking cessation and treatment project for the employees of the Ministry of Health to provide the first experience in this field. Based on the positive
outcome
of this initiative, the Ministry decided to establish smoking cessation
clinics across the country. In 2003, nine
health professionals were recruited from all four regions of the country
to run clinics locally. The UK Smoking Cessation Service, a part of the
UK National Health Service, was considered as a possible model for the
clinics. Under the auspices of WHO, the second author, who is closely involved
in the UK services staff training, was invited to run the initial training
course and to advise on local developments. The training course took place
in June 2003. The Cyprus system is going to emulate some features of the
UK Specialist Smoking Cessation Service. For example, the Cyprus service
is adopting the withdrawal-oriented model of treatment ('the Maudsley
model') together with some of the UK provision regarding data monitoring
and clinical supervision. The next step will consist of setting up the
clinics in local hospitals, and in encouraging referrals from local doctors
and nurses. There are important challenges ahead for the course participants
and especially for the service coordinator. However, some important service
elements are already in place and there is a good chance that Cyprus health
services will become one of the first to offer free intensive smoking cessation
treatment with population-wide coverage.