Project SCCoPE discusses success, eyes potential to be a cessation “game changer”

Since its inception, Project SCCoPE has been able to mark its presence felt in India, especially in the intervention states of Odisha and Rajasthan. It has received tremendous support from the state governments and the respective state level tobacco control cells. We have trained primary care physicians on tobacco cessation with an aim that cessation advice be strengthened in routine clinical practice. Tobacco users need to be effectively counseled on simple but useful ways of quitting. Messages that quitting is possible has a better chance when it comes from the doctors. Initially we found a lot of skeptics amongst doctors but once they started to do simple counselling techniques following the 3A model they were able to see some change. This motivated them to integrate this practice in their daily routine.

We have successfully trained a cluster of 80 master mentors and over 400 primary care physicians in both the states.  The success of the program was dependent on three factors:

  1. Good ownerships of programs being embedded in the public health systems
  2. Champions within the system who were able to provide supportive supervision
  3. Use of technology and aids to further improve the training as well as evaluation of the project

The success of the project has impressed the health departments of both states and now we have specific request to be the technical support unit for further expand of cessation to work to other districts.  In our intervention states, Odisha is also procuring medications as well as equipment for expansion of cessation activities for the healthcare facilities in the state. Our model, which stressed upon the viability of cessation services in primary care centres, will reduce the cost of long term care and patients will get help in determining the need for avoidable expensive treatment for a host of issues related to tobacco use. Our consistent advocacy has won us friends and champions for the cause. We are planning a two day crossover trip to both states so that the state can learn about innovation in this field from each other.

Even though some work is now being done on cessation in India not many have the rigor of a scientific evaluation. Creating evidence for policy change is as important as the intervention or an initiative itself. Without sufficient evidence, advocacy of low cost models may be overlooked and sustainability may be the casualty of simple training models. We see our technical work as a catalyst which can provide evidence for suitable scale up. This is especially in countries like India which needs feasible and appropriate low cost tobacco cessation models.

Dissemination through several local, national and international channels is equally important. So far we have shared the model at world’s conference in Abu Dhabi and the Global Tobacco Dependence Treatment Summit at the Mayo Clinic. We also received the best paper award for sharing some of the evaluation models in the International Conference on Public Health (ICOPH) 2016. We have been sharing our work within the scientific community through workshops and conferences to gather further insights from colleagues everywhere. We have also now developed collaborations with the Center for Research of Public Health (CeRAPH) at the University of Canberra to work on data sets and co-author papers using advanced econometric modelling and cost effectiveness. We also envisage sharing some of this at the upcoming SRNT conference in Florence.

We have also done extensive media engagements. Most of the work were covered by leading newspapers in the intervention districts and states. We have developed several IEC materials and tobacco manuals for the tobacco users and doctors respectively. We have a media advocacy strategy planned in March leading up to the national seminar on cessation, which we will be co-hosting along with other developmental partners.

Project SCCoPE has the potential to be a game changer in cessation in the coming years, we are also seeking resources both from Global Bridges and otherwise to keep the momentum going. Our next piece of work will be not just on expanding this model to tertiary care and private clinics but also testing the integration of cessation to NCD clinics in public health facilities.

Learn more about Project SCCoPe from Raj Panda, MD, MPH, MBBS, the author of this post in the following video from the 2016 Global Tobacco Dependence Treatment Summit.