25 May 2020

RACGP’s strong anti-tobacco advocacy work recognised

The Royal Australian College of General Practitioners (RACGP) has been rewarded for their strong anti-tobacco advocacy.

The RACGP has been selected as one of the recipients of the 2020 World No Tobacco Day awards for their valuable work including the release of new Smoking Cessation Guidelines 2020 (“the guidelines”). The guidelines provide up to date and evidence-based recommendations that can be used by a wide range of health professionals when helping patients to quit smoking.

The RACGP also put forward a highly publicised submission to the Therapeutic Goods Administration opposing the approval of “heat not burn” tobacco products in Australia as part of the organisation’s high profile stance against Big Tobacco.

The World Health Organisation’s No Tobacco Day awards is a global campaign aimed at counteracting the machinery of Big Tobacco and calling out the deliberate strategies and marketing ploys used to attract a new generation of smokers – particularly the young and vulnerable.

Nomination support letters backing the RACGP’s advocacy were received from VicHealth, Cancer Council Victoria and the Royal Australian and New Zealand College of Psychiatrists. The letters pointed not only to the RACGP’s prominence in the media but also to the fact that the guidelines were applicable across all healthcare settings and backed by the latest available evidence.

RACGP President Dr Harry Nespolon has welcomed the news.

“It is extremely encouraging that the World Health Organisation has recognised the RACGP’s strong advocacy in this vital area of public health. In Australia we have made massive inroads; however, we must remember that tobacco products still cause extraordinary harm to many people and there is much more work to be done.

“First and foremost we recommend allowing greater flexibility in prescribing for smoking cessation pharmacotherapy, including nicotine replacement therapy.

“We should introduce Pharmaceutical Benefits Scheme subsidies for combination nicotine replacement therapy, which involves using two types of these therapies together such as a patch and gum. Currently, combination nicotine replacement therapy is not PBS-subsidised yet it is proven to be the most effective form of this type of therapy.

“We also should allow GPs to prescribe a second round of PBS-subsidised nicotine replacement therapy within a 12-month period because it will help reduce relapse in people who have stopped smoking at the end of a standard course.”

Dr Nespolon said that achieving these changes was particularly important given the populations affected most prominently by tobacco use.

“As I noted during the release of the guidelines, the likelihood of smoking every day is actually three times as high in the lowest socioeconomic areas of the country compared to the highest.

“So if we can change the PBS rules and cut costs for pharmacotherapy options, including nicotine replacement therapy, we can help many more Australians quit smoking for good.

“These medicines work, we just need to do more to help get them into the hands of people who need them the most.”

The RACGP President also said that various claims and campaigns concerning tobacco control needed to be fact-checked carefully.

“When we released the guidelines it was unfortunate that our position on vaping was misrepresented by some pro-vaping organisations who claimed we were coming out ‘in support’ of vaping.

“That is not the case - as I said at the time repeatedly the RACGP does not endorse vaping. Our guideline's conditional recommendation notes that it's only a reasonable intervention in very limited circumstances and that the long-term health effects are unknown. So we need to approach it with extreme caution.

“The RACGP will continue its campaign of anti-smoking and anti-vaping messages to counter the push by Big Tobacco targeting Australian youth”.

Chair of the Expert Advisory Group behind the guidelines, Professor Nicholas Zwar, said that achieving this international recognition was a positive step forward but that there was plenty more that health professionals could do to help their patients quit smoking.

“We must not forget that the battle is far from over. Australia has achieved strong results in tobacco control and smoking rates with daily smoking nearly halved from 24% in 1991 to 12.8% in 2013.

“However, it is not all good news. There has been a slowing in the rate of decline with little change in prevalence from 2013 at 12.8% to 2016 at 12.2%. Smoking rates remain high among Aboriginal and Torres Strait Islander people and also in people with mental health issues.

“It is important for health professionals to take full advantage of our guidelines and adapt how they are helping their patients quit smoking to use the most effective and evidence-based approaches.”

The guidelines update was funded by VicHealth and the Australian Government Department of Health.
Note: The RACGP’s guideline conditional recommendation 15 concerning vaping can be found here on the RACGP website.

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