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Pre-Conference on Tobacco Free Health Care Services
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The HPH Taskforce – Tobacco Free United (TFU)
TFU is not simply a taskforces on tobacco within HPH but it is a taskforce for the development of collaboration around the theme of tobacco. TFU seeks to bring together the strong concepts, tools and activities of two networks (HPH and ENSH) and support collaboration on common actions, exchange information and promote the concepts, tools and activities of each network across the members of both networks.
Ms. Ann O’Riordan, Lead & Coordinator, Tobacco Free United Taskforce (TFU)
Dr. Shu-Ti Chiou, Bureau of Health Promotion (BHP), Taiwan Network of Health Promoting Hospitals and Health Services
Plenary 1: Keynote Lectures專題演講
Purpose and Scope of the Tobacco Free Pre Conference
The Pre Conference aims to examine and explore the evidence and potential for collaboration between HPH and ENSH and to provide an opportunity exchange and share practical examples of good practice.
“Health promoting healthcare services and tobacco-free health services – collaboration and mutual support. Findings from the PRICES-HPH evaluation study.”
Ms. Christina Dietscher,
LBI - WHO-CC
Ludwig Boltzmann Institute
Health Promotion Research, Austria
Dr. Yaw-Tang Shih, President, Taiwan College of Healthcare Executives
From Politics to People-Tobacco Control and Services in Scotland
Mr. David L Pattison,
Head of International Development,
NHS Health Scotland
Prof. Esteve Fernandez, Chair. ENSH-Global Network for Tobacco free Health Care Service
Standards, requirements and process to become a ENSH GOLD Forum member
Dr. Cristina Martinez,
Coordinator, ENSH? Global Network of
Tobacco Free Health Care Services.
Catalan Tobacco free Network
Dr. Shu-Ti Chiou: Bureau of Health Promotion (BHP),
Taiwan Network of Health Promoting Hospitals and Health Services
Ms. Christina Dietscher: Social scientist and senior researcher at the Ludwig Boltzmann Institute Health
Promotion Research (LBIHPR, Vienna, Austria).
Mr. David Pattison: Specialist Public Health Adviser and NHS Health Scotland, Head of the International
Development, a WHO CC for Health Promotion and Public Health Developments.
Plenary 2: ENSH-Global GOLD Forum
ENSH-Global GOLD Forum
The Gold Forum is an ENSH process that provides a global platform that gives recognition to members and non-members working at the highest level of ENSH standards implementation. It provides a “Learning and Sharing Forum” for the exchange of practical examples of good practice and access to experts on key aspects of implementation on tobacco free policies.
ENSH GOLD Forum:
Introduction of members and their organizations
Ms. Christa Rustler,
Lead ENSH GOLD Forum
Health Care Plus UG, Germany
Dr. David Chalom, Doctors against Tobacco Sweden and
Tobacco Free United Taskforce (TFU)
Presenting Forum Members 金獎醫院發表
· Taiwan Adventist Hospital - 醫療財團法人臺安醫院
· St. Martin De Porres Hospital - 財團法人天主教聖馬爾定醫院
· Cathay General Hospital -國泰醫療財團法人國泰綜合醫院
· Jianan Mental Hospital - 行政院衛生署嘉南療養院
· Taiwan Landseed Hospital -壢新醫院
· ICO Hospitalet, Cataluna, Spain
Results, Good Practice and Challenges ENSH Standard 1 and 2
Results, Good Practice and Challenges ENSH Standard 3&4 and 5&6
Shih-Tzu Tsai, President of Taiwan Medical Alliance for the Control of Tobacco
台灣醫界菸害防制聯盟/花蓮慈濟醫院 蔡世滋 理事長/主任
Lunch Break 午餐
Results, Good Practice and Challenges ENSH Standard 7&8 and 9&10
Chi-Pang Wen, Professor, National Health Research Institutes, Taiwan
台灣醫界菸害防制聯盟 / 國家衛生研究院 溫啟邦 教授
Plenary discussion on ENSH GOLD Forum
- Highlights, Challenges, Innovation, results and good practice
Ms. Christa Rustler,
ead ENSH GOLD Forum, Health
Care Plus UG, Germany
Summary of Best Practice Presented at ENSH GOLD Forum meeting
Dr. Shu-Ti Chiou, Director
Certificates and Pictures頒獎與合影
General, Bureau of Health
Promotion, Department of Health, Taiwan
Dr. Cristina Martinez: Coordinator, ENSH? Global Network of Tobacco Free Health Care Services.
Nurse Coordinator Catalan Tobacco free Network
Ms. Christa Rustler: Nurse and Health Communication and Quality Management Specialist. CEO of
Health Care Plus and Lead for the ENSH-Global GOLD Forum.
Ms. Ann ORiordan: Nurse and Health Promotion Specialist and Lead for the Collaborative HPH Taskforce
Tobacco Free United (TFU)
Dr. Shu-Ti Chiou
Our distinguished guests, dear partners and colleagues, good morning!
In 2006, Taiwan established the first network of health promoting hospitals and health services in Asia. Not long after that, we became the first member from the Asia-Pacific region to join the ENSH Global Network for Tobacco Free Health Care Services in 2011. I am delighted to tell you that our 53-member hospitals in 2011 is going to welcome 60 more new-comers in 2012. It shows that the health care system in Taiwan, in addition to providing high quality services, also paying attention to health promotion among patients, their families, employees as well as those in the communities. We are very honored to have 7 internationally renowned experts with us in the ENSH GOLD Forum. They are: Professor Esteve Fernandez (Chair, ENSH-Global Network for Tobacco Free Health Care Services) from Spain, Christina Dietscher (Senior Researcher at the Ludwig Boltzmann Institute Health Promotion Research) from Austria, Ann O'Riordan (Lead for the Collaborative HPH Taskforce, Tobacco Free United) from Ireland, Cristina Martinez (Coordinator, ENSH-Global Network of Tobacco Free Health Care Services) from Spain, Christa Rustler (CEO of Health Care Plus) from Germany, David Chalom (Doctors against Tobacco Sweden and Tobacco Free United Taskforce) from Sweden, and David L Pattison (Head of International Development, NHS Health Scotland) from United Kingdom. I believe their experience sharing will be instrumental in promotion of tobacco-free health care services in Taiwan.
Since the Tobacco Hazards Prevention Act came into effect and created a relatively smoke-free public space, our citizens have been protected from over 90% of environmental tobacco smoke. However, smoking rate among adult male remains as high as 33.5%, which is 1.6 times of the United kingdom and clustered in the working labors of lower social economic status. Malignant tumors, heart disease, cerebrovascular disease, pneumonia, injury, chronic respiratory diseases, hypertensive diseases, etc. were among the top 10 causes of death in 2010. They all are linked to smoking. According to vital statistics from 1960 to 2010, life expectancy has extended to 76.2 for men and 82.7 for women, but the gap between them widened from 4.1 to 6.5 years. It has to do with men’s increased tobacco consumption at a pace much higher than their women counterparts after World War II. As a result, men suffer from higher tobacco-related mortality.
The world's first international treaty on public health, WHO Framework Convention on Tobacco Control (FCTC), in Article 14, mandates that governments develop national programs of cessation and treatment for tobacco dependence. Guidelines to carry out the mandate should be integrated, comprehensive and based on scientific evidence. Tasks include systematic identification of tobacco users, counseling, quit-line, face-to-face support from trained staff, increasing accessibility and affordability for pharmaceutical products. Above all, cessation of tobacco use should be made available in all sorts of locations within and beyond the health care system.
Smoking is a problem that can be solved, a disease that can be cured. However, it continues to be the number 1 killer in Taiwan, causing 18,800 deaths every year. In 2002, Taiwan decided to levy cigarette tax to fund cessation services. Unfortunately, although a smoker is funded NT$250 weekly for drugs, he or she has to bear additional NT$550-1,250 out-of-pocket a week. This has created economic barrier for those in the lower socioeconomic class. A great challenge lies before us to really help those in need and eliminate inequalities in health.
There are different methods for smoking cessation, including a piece of advice, short-term counseling, long-term counseling and pharmacological approaches, all of which can help one quit smoking at different levels. More than that, care from health professionals, support and love from family members are also useful. How effective is a piece of brief advice? Clinical research shows that physician's brief advice versus no advice detected an increase of 2-3 successful quitting out of 100 patients. An individual stopping smoking equals to NT$420,000- worth social benefits in the next 10 to 15 years. In other words, if you deliver advice to 100 smokers a day, you are helping 2-3 extra smokers to quit, then you save NT$840,000 to 1.26 million for the society. To make one quit smoking, NT$10,000 will be saved. Delivery of advice is worth a lot, not hundreds but thousands! It takes only a piece of advice. From time to time, health care providers come across patients who smoke, so to each patient we shall ask whether he smokes. If the answer is yes, we should sincerely and firmly tell him, "Sir, you must quit, it is very important for your health." In doing so, we save tremendously for the whole society. Of course, the government is ready to support all these efforts, including 2A1R（Ask, Advise, Refer）and ABC（Ask, Brief advice, Cessation ). Even a brief A (Advice) can be significant.
Our country just celebrated her centennial anniversary. In the beginning of a new era, we made "halve smoking rate in 10 years" our new resolution. To this end, the "Second Generation Smoking Cessation Project" initiated by the Department of Health took off on March 1, 2012. It covers those from outpatient, inpatient and emergency units. In addition, the project also provides health education and cessation service in community pharmacies. Smoking cessation drugs will be paid for with cigarette tax and supplied to patients according to NHI's copayment scheme. In the NHI scheme, people from low income households, indigenous area and offshore islands are exempt from copayment. This service is available nationwide in 2,000 healthcare facilities, covering 96% of townships in Taiwan.
Since tobacco is the number one killer in Taiwan, the healthcare organizations and health professionals are expected to play a more significant role in its treatment and prevention in order to save more lives, in addition to complying with the total smoking ban in their campus. The model of tobacco-free health care service can assist hospitals and health services to fulfill this role. During 2011 and 2012, we have had about 113 hospitals joining the ENSH-Global Network for Tobacco Free Health Care Service certification process. They are on the way to become part of the big family. It clearly shows that combating smoking has become a collective endeavor among us all.
I have no doubt that the ENSH GOLD Forum 2012 will be a great opportunity to share lessons learned and achievement both in Taiwan and partner countries. This is also an event where Taiwan can demonstrate its efforts and commitment to partners around the globe. It makes me proud to know that 5 hospitals will receive ENSH GOLD Award this year. Congratulations to you! I hope you will keep the GOLD Award in Taiwan for good and be role model for upcoming candidates.
I would like to thank the tremendous contributions made by public health worker, health professionals and healthcare managers. I sincerely encourage every physician, pharmacist, nurse, counselor and health educator in every health care organizations to be proficient in knowledge and skills on smoking cessation and take every single opportunity to help smokers quit. By doing this we are all promoting better healthcare quality, better health gains both for smokers and nonsmokers, and a smoke-free global community.
Once again, I extend my heart-felt gratitude to all participants. I wish the ENSH GOLD Forum a huge success.
Shu-Ti Chiou, M.D., Ph.D, M.Sc.
Director-General, Bureau of Health Promotion, Department of Health, Taiwan
手冊封面（The cover of “ Pre-Conference on Tobacco Free Health Care Services ” brochure.）
無菸醫院國際金獎頒獎（The group picture of Dr. Shu-Ti Chiou with 6 awarded hospitals’ representatives and all distinguished guests.）