Overview
- A multi-institution review published this week in the New England Journal of Medicine found about 1.3 billion people — most of them in low- and middle-income countries — do not have adequate services to help them quit tobacco.
- Reports of how many countries meet the WHO gold standard diverge because authors and coverage used different definitions, with summaries citing either 13 countries that offer behavioral counselling plus subsidized medication or 31 countries under a broader measure.
- The review shows access is shaped by local factors such as health financing, cultural norms, government policy, and direct political interference from the tobacco industry.
- Authors recommend scalable, low-cost delivery options including national quitlines, mobile apps, community health workers, and routine clinic screening systems like Ask-Advise-Connect, and they urge global licensing and full coverage of nicotine replacement therapy, cytisine, and varenicline.
- Wider access to these services and medicines could prevent millions of tobacco-related deaths and save health costs over time, but change will require governments and insurers to adopt financing and regulatory reforms tailored to each country.