Abstract
The objective of this study is to assess the situation of hospital-based smoking cessation clinics in
Thailand from 2007 to 2012 by conducting literature review and assessment in 10 sites supported by
National Health Security Office (NHSO) in order to identify success factors and good practices for scaling
up. The result shows that there are four models such as hospital-based cessation clinics, Quitline service,
cessation services in pharmacies with full-time pharmacist and by dental clinics in public health centres
under Bangkok Metropolitan Authority. Two systems were developed to achieve universal access to
cessation service such as Quitline 1600, cessation clinics supported by NHSO, including SMART Quit
Clinic. Clinical practice guidelines for treating tobacco dependence by physicians and other health professionals,
for which the contents of the guideline can be adjusted to suit each profession, were also issued. In
the ten smoking cessation sites, the structure and services differ slightly depending on the context and
size of hospital. The 5A’s system (Ask, Advice, Assess, Assist and Arrange) was fully integrated into
routine work in all departments without referring the smoker clients to the smoking cessation clinics.
Usually providing consultations and parallel medication are offered. Plans for rehabilitation and followup
with support from network outside hospitals such as health centres and volunteers are the key performance
indicators
This study recommends: 1) In collaboration with organizations involved or with capacity to be
involved in existing cessation services, make services for smokers a special program under NHSO to
improve central and regional systems. 2) To plan and integrate Thai cessation services into one system, set
up a workgroup with clear organizational policies as the responsible body for all levels from ministerial,
regional, district to provincial level. 3) To develop up-to-date educational media for use by cessation
clinics through which standardized cessation techniques can be taught. Provide channels for continuous
report and public relation including seminar, training and research dissemination where those responsible
for cessation clinics are invited. 4) To have personnel throughout the country trained under the same
system, set up a central office responsible for setting consultation and treatment training standards. 5) To
have service conditions set; for patients with chronic diseases make cessation a condition for receiving
services.
