Croatia ranks third in the EU according to the number of smokers. Capak: ‘We have room for new measures’

The conclusions of the conference “Smoking addiction – what is Croatia doing?” which brought together family doctors and other health experts, pharmacists, representatives of the public health community, academia, and industry, with the aim of discussing possible and effective solutions for reducing smoking and smoking-related diseases in Croatia.

The Croatian Institute of Public Health has a number of projects, from education through the school medicine service, through organized psychosocial help to smokers through the addiction prevention service, we have an info phone and a very comprehensive info page of the institute dedicated to addictions, including smoking, and we still have room for the introduction of new measures – he said. associate professor, Ph.D. Krunoslav Capak, director of the Croatian Institute of Public Health (HZJZ).

Marija Savić from the Croatian Institute of Public Health presented a series of methods of combating smoking that are evaluated in a structured way through the Committee for Evaluation and Certification of Addiction Prevention Programs and Projects, which was formed at the HZJZ, in order to know which are the most effective, which can be certified and further encouraged.

Initiative of family doctors

Family doctors launched a project to educate colleagues on the approach to smokers and on scientifically effective methods for quitting smoking, a new edition of the smoking cessation guide was presented, which helps family doctors in talking with patients, as well as preliminary results of research on CO levels in the exhaled breath of smokers and users of new smokeless products.

– As family doctors and the first contact with patients, we want to play a greater role in the fight against the most common risk factors for the onset of chronic diseases that we encounter every day, among which is smoking. What we can do is educate family medicine teams, pharmacists and our patients about all the products we have on the market. When we talk about nicotine addiction, in addition to cigarettes, we have a number of new products, and it is extremely important for us to record the users of all these products, which is not yet possible for us through the health records of patients. Without such records, we cannot monitor their impact on health. We launched a project to educate family doctors, their nurses/technicians and pharmacists, created an educational manual that was supported by the Ministry of Health and the Croatian Institute of Public Health, and started with educational workshops aimed at helping health workers in the fight against this mass addiction, said the Prime Minister. Dr. Ines Balint, family physician and president of the Primary Health Care Commission in the Croatian Medical Chamber.

Balint briefly presented the preliminary results of the research on CO levels in the exhalation of smokers and users of new smokeless products, which currently includes 60 smokers and users of smokeless products in 4 family medicine practices in various parts of Croatia.

Balint pointed out that the research clearly shows that smokers repeatedly try to quit smoking, almost a third of them, the research showed, unsuccessfully tried to quit smoking more than 5 times, which indicates that they need more systematic help. She emphasized that the research will continue and that she will try to record more users of smokeless products, which for now show lower levels of CO in the exhalation than cigarette smokers.

– We still have a lot of room for educating fellow family doctors on smoking cessation methods, and I believe that strengthening the capacity of family doctors in the fight against smoking is precisely the potential in the system that can turn around things that are not changing in Croatia anymore. a number of years. In order to help them in talking with patients along with education, we created guidesč for smokers intended specifically for their patients, where they can find advice from our and foreign experts on smoking cessation methods – said Dr. Iva Petri, family physician.

Dr. Ivan Damašek, a psychiatrist at the KBC Osijek Psychiatry Clinic, spoke about the complexity of nicotine addiction and confirmed that for success in quitting smoking, it is important to have as many effective methods available as possible because insisting only on abstinence does not give the best results.

‘The industry has a responsibility’

– The industry wants to be part of the solution in reducing the prevalence of smoking. We believe that we have enough scientific evidence that shows that our smokeless products are less harmful than cigarettes, so that by encouraging the transition of adult smokers, who cannot or will not quit smoking, to these products, we can make a generational shift in reducing smoking. The best example is Sweden, which was able to reduce the proportion of smokers in the population to 5.3 percent with this very approach. An important product in this approach in Sweden are nicotine pouches, which are smokeless products that do not contain combustion, tar, smoke or secondhand smoke and according to publicly published studies (available on OmniTM) have 99 percent* less harmful substances than cigarettes. Along with the quality regulation of smokeless products, which encourages the transition of adult smokers to these products, it is important to do everything to prevent the availability of all tobacco and nicotine products to minors. At BAT we are clear – none of these products are for minors and should not be available to them. In Croatia, we therefore launched a project a year ago to introduce innovative technology for determining the age of majority in the national iNovina chain of kiosks, which provides additional protection against the sale of tobacco and nicotine products to minors. In the first year, over 41,000 scans were carried out and more than 12,000 educational brochures were distributed to minors and their parents. We believe that with our scientific work, product development, but also with projects like this, we show that we are only a responsible and constructive participant in reducing smoking, said Hugo Tan, chief medical officer of BAT.

‘Regulation of new products should be reasonable’

Asst. Ph.D. Danko Relić, a member of the European Economic and Social Committee, referred to the issue of regulation of new nicotine products, with special emphasis on nicotine pouches. He pointed out that there is a clear ban on selling to minors in Croatia, but that this product category still does not have a complete regulatory framework. Relić emphasized that this gap should be filled with proportionate and feasible solutions, relying on existing examples from the European Union that enable regulated availability, public health supervision and education. At the same time, he pointed out that the industry can only be part of the solution if it operates under clear public health rules. Such an approach prevents disorder in the market, protects young people and consumers, and avoids disproportionate bans that can encourage the development of an illegal market.

In the panel discussion, it was emphasized that there is no simple solution against smoking, which is why we need to discuss as much as possible and use new knowledge from science and good practices of the countries that are most successful in the fight against smoking. Nicotine addiction is legal, not illegal, so it is necessary to understand how to help patients on an individual level, stressed Dr. Dragan Soldo, president of the Croatian Association of Family Doctors (HDOD) and in that context, sees smokeless products, for which there is evidence that they are less harmful than cigarettes, as a possible part of the path towards quitting smoking.

Olgica Velkovski Škopić, mag.pharm., deputy president of the Croatian Chamber of Pharmacy emphasized that smoking patients can seek help from in a pharmacy where nicotine replacement therapy is available, in consultation with pharmacists.