National Tobacco Control Program (NTCP)

National Tobacco Control Program (NTCP)

About: The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than 8 million people a year around the world. More than millions of those deaths are the result of direct tobacco use while around 1.2 million are the result of non-smokers being exposed to second-hand smoke. Around 80% of the 1.1 billion smokers worldwide live in low- and middle income countries, where the burden of tobaccorelated illness and death is heaviest. Tobacco use contributes to poverty by diverting household spending frombasic needs such as food and shelter to tobacco. Government of Indialaunched the National Tobacco Control Programme (NTCP) in the year 2007-08,during the 11th Five-Year-Plan. Baseline data generated through the Global Adult Tobacco Survey (GATS) India 2009-2010, indicating high level of prevalence of tobacco use, it was up scaled in the 12th Five Year Plan with a goal to reduce the prevalence of tobacco use by 5% by the end of the 12th FYP. As per the second round of GATS, the number of tobacco users has reduced by about 81 lakhs (8.1 million).  In all 30 Districts of Karnataka, NTCP is implemented, in Ramanagara District, NTCP was implemented During 2018-19FY.

OBJECTIVES OF NTCP:

(i) Create awareness about the harmful effects of tobacco consumption.

(ii) Reduce the production and supply of tobacco products.

(iii) Ensure effective implementation of the provisions under “The Cigarettes and Other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003” (COTPA)

(iv) Help people to quit tobacco use, and

(v) Facilitate implementation of strategies for prevention and control of tobacco advocated by WHO Framework Convention of Tobacco Control.

STRUCTURE OF NTCP:

The National Tobacco Control Cell (NTCC) at the Ministry of Health and Family Welfare (MoHFW) is responsible for overall policy formulation, planning, implementation, monitoring and evaluation of the different activities envisaged under the National Tobacco Control Programme (NTCP). The National Cell functions under the direct guidance and supervision of the programme in-charge from the MoHFW i.e. Joint Secretary. The technical assistance is provided by the identified officers in the Directorate General of Health Services.

NATIONAL LEVEL:

➢ Public awareness/mass media campaigns for awareness building and behavioral change

➢ Establishment of tobacco product testing laboratories at National level

➢ Mainstreaming research and training on alternative crops and livelihood with other nodal Ministries.

➢ Monitoring and evaluation including surveillance

➢ Integrating NTCP as a part of health-care delivery mechanism under the National Health Mission framework.

STATE LEVEL:

Dedicated State Tobacco Control Cell for effective implementation and monitoring of tobacco control initiatives. The key activities include;

➢ State Level Advocacy Workshop

➢ Training of Trainers Programme for staff appointed at DTCC under NTCP.

➢ Refresher training of the DTCC staff.

➢ Training on tobacco cessation for Health care providers.

➢ Law enforcers training / sensitization Program

DISTRICT LEVEL:

Dedicated District Tobacco Control Cells for effective implementation and monitoring of tobacco control initiatives. The key activities include;

➢ Training of Key stakeholders: health and social workers, NGOs, school teachers, enforcement officers etc.

➢ Information, Education and Communication (IEC) activities.

➢ School ProgrammesMonitoring tobacco control laws.

➢ Setting-up and strengthening of cessation facilities including provision of pharmacological treatment facilities at the district level.

➢ Co-ordination with Panchayat Raj Institutions for inculcating concept of tobacco control at the Grassroots

The main thrust areas for the NTCP are as under:

1. Training of health and social workers, NGOs, school teachers, and enforcement officers;
2. Information, education, and communication (IEC) activities;
3. School programmes;
4. Monitoring of tobacco control laws;
5. Coordination with Panchayat Raj Institutions for village level activities;
6. Setting-up and strengthening of cessation facilities including provision of pharmacological treatment facilities at district level.

TRAINING:        

        The key thrust areas under the National Tobacco Control Programme include trainings of health and social workers, NGOs, school teachers, and enforcement officers The need for capacity building is fundamental to implement tobacco control policies to stave off the tobacco epidemic. Training is one of the vital components of the Programme.

              Capacity building of the States/UTs is desirable for proper implementation and monitoring of the programme. Training and capacity building for tobacco control should be undertaken through State level advocacy workshops/sensitization programmes. Efforts should be directed to involve all the State government departments for tobacco control. Specific/tailor made trainings are organized for, Police, Food & Drug Administration (FDA), Health / Medical Professionals, Judiciary, Academicians, Students, Media etc. They also work very closely with NGO partners and involve them in advocacy workshops. The State Cell also organize Training of the Trainers Programme (ToT) for the District Tobacco Control staff appointed followed by refresher training at regular intervals. The trainings are organized at regular intervals and properly spaced in each quarter. Efforts are being made to integrate training with other health programmes such as NPCDCS, RNTCP, and others to maintain synergy. For conducting the State Level Trainings/Workshops, the existing State NHM norms should be used.

Tobacco Cessation Centre (TCC):

Focus Group Discussion involves gathering people from similar backgrounds or experiences, to bring them together to discuss a specific topic of interest. It is a form of qualitative research; here questions are asked about their perceptions attitudes, beliefs, opinion ideas, habits etc. In National Tobacco Control Program, FGD is conducted with identified tobacco users in a village; taluk and district level. and motivate them to quit tobacco consumption. It can be done with Self Help Group Meeting, Colleges, Youth Clubs, Parents Meeting at School and Colleges, Health Camps, Rotary club/Lions club, NGOs etc. Those who quit tobacco completely can share his/ her experience to motivate others. Tobacco victims and cancer patients can be invited to talk on tobacco ill effects and benefits so quitting tobacco. It can be done by using tobacco ill effects flipchart, posters and showing anti tobacco videos. Discussion should not only highlight the health hazards of tobacco, but it should also showcase the economic consequences on “how tobacco ruins a household”, “Economic Burden of tobacco”, “Social burden of tobacco” etc. The psychologist has to show them a different angle about their cultivated habit, how quitting will be beneficial to him/her in different was. At end of the FGD, psychologist should explain services available in Tobacco Cessation Centre and refer him to Psychiatrist working under DMIIP Program for any higher treatment, to those who are willing to seek tobacco cessation service. Educative materials, flipcharts, reading materials are given to FGD participants. Ideally, one FGD group consists of 1015 people. NTCP Psychologist has to be actively involved along with other NTCP team members. Counselor Psychologist under NTCP  has to organize 4 such FGD’s in a month.

Telephonic Counseling/Phone Therapy:

 Considering the current situations we encourage our Counselors/Psychologist to undertake “Telephonic Counseling” also called “Tele-therapy” or “Phone Therapy”. Phone Therapy or Phone Counseling is the process of talking to a client via telephone/Skype to resolve mental health issues. Telephone Therapy can be found effective in adolescents can be done through telephone or even Skype calls. Recent studies show that telephone therapy has much therapeutic value as Face to Face to therapy. It also can be used to supplement Online therapy sessions, send reminder SMS for follow up appointments etc,Considering current scenario, TCC is a way of helping people who do not have means or opportunity to attend face toface sessions, and to receive the help that they want to receive.

IEC: Information, Education and Communication (IEC) activities.

IEC is one of the major components of the District Tobacco Control Programme. District -wide IEC or public awareness campaigns have also been launched in the print and electronic media for dissemination of various provisions of the Act. This included publicity in  District / Regional newspapers, private and Government Radio & TV channels and dissemination of publicity materials such as posters, stickers, handouts, factsheets etc. Dedicated spots have been developed as well as adopted from the global best practices. The Campaigns are aired through the Government as well as Private Channels for both video/TV as well as radio/FM. Accordingly, there is also provision of dedicated funds for carrying out IEC activities at State/district level.

1. School Programmes
2. Rose Campaign
3. Yellow line campaign
4. Other IEC activates

Health Effects of Tobacco: 

1. Cancer of oral cavity, tongue, larynx and pharynx, esophagus, stomach, gall bladder, urinary bladder, uterine cervix and lungs.
2. Cardio-vascular Diseases and Chronic Obstructive Pulmonary Diseases [COPDs] linked with the Tuberculosis.
3. 40% of TB and other related diseases are attributed to tobacco consumption.
4. Oral diseases
5. Low-birth weight babies
6. Reduced fertility and sexual impotence among men.
7. Early ageing and wrinkling of skin.
8. Pre-mature deaths,
9. Cancers: 50% of cancers in males and 20% cancers in females are attributed to tobacco use,
10. Majority of cardio-vascular and lung disorders.

About the WHO Framework Convention on Tobacco Control

The WHO Framework Convention on Tobacco Control (WHO FCTC) is the first international treaty negotiated under the auspices of WHO. It was adopted by the World Health Assembly on 21 May 2003 and entered into force on 27 February 2005. It has since become one of the most rapidly and widely embraced treaties in United Nations history.

The WHO FCTC was developed in response to the globalization of the tobacco epidemic and is an evidence-based treaty that reaffirms the right of all people to the highest standard of health. The Convention represents a milestone for the promotion of public health and provides new legal dimensions for international health cooperation.

National Tobacco Quit Line Services (NTQLS) – 1800 112 356 (TOLL FREE)

The Government has established a National level tobacco cessation Quitline in Vallabhbhai Patel Chest Institute (VPCI), New Delhi with a toll free number (1800-112-356) and the services have been expanded to regional satellite centres since 2018 and counseling is now available in regional languages at Dr. Bhubaneshwar Borooah Cancer Institute (BBCI), Guwahati; National Institute of Mental Health & Neuro Sciences (NIMHANS), Bangalore; and Tata Memorial Centre (TMC), Mumbai.

mCessation – 011-22901701

The Government has also developed and deployed a mobile-based strategy called m-Cessation (011-22901701) to encourage and support those who are desirous of quitting. In this strategy, those desirous of quitting give a missed call to a toll free number.

Link to mCessation Website: https://www.nhp.gov.in/quit-tobacco

TO QUIT TOBACCO, CALL 1800 112 356 (TOLL FREE) OR GIVE A MISSED CALL AT 011-22901701