In Brazil, 443 people die daily from the consequences of smoking. The numbers are from the National Cancer Institute (Inca) and call attention to the National Anti-Smoking Day campaign, celebrated this Sunday (29/8).
According to Inca, the Covid-19 pandemic negatively influenced the treatment of smokers in the Unified Health System (SUS). Data show that care for these patients had a drop of 66% in 2020.
The numbers were collected by the National Tobacco Control Program (PNCT). The reduction in 2020, compared to the year 2019, also had impacting results if the regions of the country were observed.
In the North, the fall was 59%, and in the Northeast the reduction was 66%. In the Southeast and Midwest, the falls were 68% and 63%, respectively. In the South of the country, the impact was 62% in the number of assistances, compared to 2019.
According to the Institute of Clinical and Sanitary Effectiveness, of the 161.8 thousand annual deaths attributed to smoking, 37,600 correspond to Chronic Obstructive Pulmonary Disease (COPD). In addition, of the total deaths, 33,100 are related to heart disease. As for cancer diseases, 24,400 deaths are linked to lung cancer, and another 25,600 to other cancers.
In addition, passive smoking and other causes generate 18,600 deaths per year. Victims of the disease also suffer from pneumonia and cerebrovascular accident (CVA): the problems correspond to 12,200 and 10,000 of the total annual deaths, respectively.
Data on the drop in attendances are in the report Tobacco Treatment in SUS During the Covid-19 Pandemic – Results, by Inca.
According to the coordinator of Prevention and Surveillance at the institute, Liz Almeida, the impacts are due to the reduction in demand for hospitals and health facilities during the pandemic.
“The pandemic had a very large effect on this offer in demand for smoking treatment in the SUS network, mainly motivated, on the one hand, by the fact that the population was advised to avoid leaving the house”, he explains.
She also points out that a large part of the health teams at the units needed to redirect professionals to provide care to Covid. “Furthermore, in the units themselves, several professionals were absent, because they were elderly, had comorbidities, were pregnant, breastfeeding,” says the coordinator.
According to Inca, about 68 thousand patients were treated against smoking in the SUS in 2020. Organization data show that the problem costs R$ 125 billion to public coffers to cover expenses with diseases caused by cigarettes.
How does the treatment work?
The coordinator of Inca explains that smoking is a chemical disease, mediated by the brain. “Like all dependencies, it has a long treatment”, he points out.
She draws attention to the consequences that the problem can bring to health: in addition to cardiovascular and respiratory diseases, the patient can be affected by more than 18 types of cancers associated with smoking.
Liz explains that the treatment offered by SUS is complete: “At the health unit, the professional will assess the speed of smoking and the possibility that the patient already has comorbidities associated with tobacco use. Depending on the case, the person will be referred to individual care or group care, or they can cooperate with both,” he says.
Patients can also use medications, depending on the degree of the disease, prescribed by health professionals. People in the care group have sessions for four weeks at a time.
“After these four weeks, the cases that can go to maintenance and the cases that will go back to individual care are re-evaluated”, points out the specialist.
“As the person leaves the four sessions, he enters maintenance, initially in fortnightly sessions, in the first month. Afterwards, she enters monthly sessions until she is one year old. It is a treatment very well monitored by the health team”, he points out.
Impacts and solutions
Liz Almeida assesses that the drop in the number of consultations was “significant”. For the specialist, it is important that health units study the best way to resume the service in a way adapted to the new reality imposed by the pandemic.
“Any treatment you discontinue, the resumption is always more difficult. We have to rescue all these people who are no longer served. With the succession of new pandemic waves, we understand that we will need to readjust our entire form of assistance”, he points out.
She says that some units in the country carried out teleservices or actions on social networks during the year 2020, but points out that not all regions were able to adapt to the digital model.
“The next stage of our research is to understand, together with the state coordinations, which were the factors related to the worst result, to a more accentuated drop in attendances, and the factors that also facilitated greater maintenance of these treatments”, points out the coordinator.
The expert continues: “Based on this experience, we will then examine what new steps we have to take. What are the alternative treatment modalities that we have to offer during the pandemic?”.
Liz draws attention to the importance of patients to continue looking for health facilities to complete the treatment. “The delay in stopping the use of this substance can indeed delay your physical recovery and increase the risk of developing serious diseases.”