Wednesday, 20 November 2013

Smoking cessation clinics in China are underused, face closure

Any smoker will tell you that kicking the habit is tough. Given the fact that medical journal The Lancet estimates China has over 300 million smokers, one would think that facilities designed to help them quit would be popular.
Despite the fact that lung cancer rates in China are soaring and the number of lung cancer patients could reach 1 million by 2025, the prospects of "smoking cessation" clinics around the country are looking dim.
"The clinic opens once a week and it is rarely visited. It would be counted as 'too many' if three smokers showed up. Sometimes I question whether we are wasting medical resources here," an anonymous doctor working with a smoking cessation clinic in Shanghai told the Global Times.
Despite the low traffic, Xiao Dan, a research fellow with the World Health Organization Collaborating Center for Tobacco and Health based in Beijing Chaoyang Hospital, said that utilization rates are increasing. The smoking cessation clinic affiliated with her hospital was first launched in 1996 and now sees roughly 1,000 patients a year, an increase over previous years.
But even if usage is slowly increasing, smoking cessation clinics across the country face the strong likelihood of being shut down. Zhongda Hospital in Nanjing, Jiangsu Province, is close to being shut down with only two or three smokers coming in every month over the past three years, according to the Nanjing-based Xinhua Daily. Four out of nine smoking cessation clinics in Kunming, Yunnan Province have already been shut down, the Kunming Daily reported.
Zhi Xiuyi, head of the Lung Cancer Treatment Center of Xuanwu Hospital in Beijing, said that a key problem facing these clinics is that few smokers willingly seek professional help. Many smokers reached by the Global Times said they were unaware of the clinics. They said that because smoking itself is not a disease, they would not visit a clinic for it and would rather deal with the habit on their own.
Doctors reached by the Global Times pointed out that most patients only agree to go to the clinics after they develop smoking-related health problems. "There is not enough publicity about us and many smokers are not aware that they are addicted to cigarettes. Some are ignorant of the hazards of smoking. Our patients usually come to us for a consult after noticing our logo at hospitals," said Xiao, adding that the government only offers limited support, which means that additional costs are a deterrent to patients, and that clinics do not have the necessary equipment.
"It can cost up to 3,000 yuan ($492) for a three-month course of treatment at a clinic. Since some medicines are not included in the health care system, these fees may have further hindered the clinics' development," Zhi said. He also argued that the system should at least cover the medical expenses of smoking cessation treatment for those suffering from cardiovascular or respiratory diseases, as smoking would worsen their health.
Yang Gonghuan, former deputy director of the Chinese Center for Disease Control and Prevention, said that 91.4 percent of Chinese smokers have not received any services on smoking cessation and the relapse rate is 30 percent, the People's Daily reported.
In 2012, Chen Zhu, former health minister, said that health care reform should promote reductions of tobacco use by including smoking cessation medicines into the system. The Beijing municipal government was mulling this plan in October, the Nandu Daily reported.
Source: Global Times

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