1. Bruce J Kirenga, Rupert Jones and Siân Williams
Rapid Assessment of the Demand and Supply of Tobacco Dependence Pharmacotherapy in Uganda
Bruce J Kirenga, Rupert Jones and Siân Williams

2. Last week

3. Rationale Smoking cessation a key component of tobacco control
Article 14 of the WHO Framework Convention on Tobacco Control (WHO FCTC) states that:
“each Party … shall take effective measures to promote cessation of tobacco use and adequate treatment for tobacco dependence”

4. Background Population smoking prevalence in Uganda is low (7.9%)
Increasing esp among young
(Tobacco companies are targeting the young in Africa)
Prevalence not known in patients with smoking related diseases
Not known if tobacco dependence pharmacotherapy (TDP) is accessible and affordable
33% in Masindi
44% of COPD patients
30-39yr men 65% smoked

5. Aims
To determine:
the prevalence of current smoking among in-patients with a tobacco attributable disease (TAD) at Mulago hospital in Uganda.
whether patients perceive that cost is a barrier to their use
supply of TDP in pharmacies.

6. Methods: Supply and demand of TDP
Demand: Survey of in patients with TADS:
Chronic obstructive pulmonary diseases (COPD)
Lung cancer
Asthma
Cardiovascular disease
Stroke
Diabetes.
Supply: survey of Pharmacies on availability and cost of TDP

7. In patient survey methods
Admitted from 1 June to 13 June 2015.
Medical officer performed daily rounds on the wards to recruit patients.
All consenting patients with a TAD were included.
Data:
smoking status
duration of smoking
products smoked
willingness to quit
willingness to pay for TDP.

8. Prevalence of smoking, desire to quit and willingness to pay for TDP
Patient characteristics
66 invited; 56 participated
40 (71%) were male.
Mean age 57.5 years
Prevalence of smoking (n=56)
63% current smokers
36% former smokers
1.8% never smoker.
Desire to quit and willingness to pay
77% desired to quit
37% willing to pay for the drugs.

9. Availability of TDPs 38 pharmacies were surveyed Availability of TDPs
36 private
1 public
1 private not for profit
Availability of TDPs
7 (18%) pharmacies had any form NRT
3 had bupropion
1 had nortriptyline
0 had varenicline
Mean cost for a month of:
NRT $15.7
Buproprion $17.3

10. Summary and recommendations
high prevalence of smoking in patients with a tobacco attributable disease
high desire to quit
high degree of willingness to pay
very limited availability of TDP
for Tobacco Control Framework to be implemented TDP should be made AVAILABLE and AFFORDABLE