Cessation coverage in Argentina: A qualitative study about its barriers and facilitating factors

Objective: To identify barriers and facilitating factors for the inclusion of tobacco cessation treatment coverage in the Argentine health system and to outline priority health policies for the development of smoking cessation programs.

Methods: A qualitative methodology was used based on in-depth interviews conducted with key informants from the State, NGOs and the health insurance sector.

Results: Nine barriers were identified: tobacco consumption is not appreciated as an addiction or illness; lack of a culture of prevention in the health system; lack of agreement on the relevance of coverage in all clinical cases; mistrust about policy-making decisions made under pressure from various lobbies; lack of agreement about the importance of the different components of cessation; fear of overloading the health system with additional expenses; prioritization of other tobacco control interventions as being more effective; health professionals not completely trained to deliver cessation treatment. Four main facilitating factors were recognized: consensus about the necessity of cessation treatment coverage; magnitude of the problem of tobacco use; pressure from a more informed society for the inclusion of coverage; the emergence of new paradigms for the inclusion of health public policies.

Conclusions: The barriers create a vicious circle: members of the health care system do not fully appreciate the issues related to smoking, which leads to an inappropriate set of priorities resulting in a lack of preventive policies and insufficient health practices and interventions to curb the problem. However, this situation is changing since the facilitating factors are gaining strength, an observation supported by the changes witnessed in Argentina over the last few years.