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[Curing smoking: a priority health objective].

Cigarette smoking is the number one avoidable killer in the industrial world. Yet doctors frequently do not treat or prevent the disease as they should. Education and training are lacking. In the present article an overview of these and other smoking-related problems and, at the same time, a description of the practical management of an outpatient clinic for smoking cessation, the epidemiology of smoking, the related risks and mortality, as well as the advantages of quitting are presented. The toxicology and pharmacology are discussed, in relation to addiction and craving. The article also includes the diagnosis of nicotine-dependence and nicotine replacement as well as bupropione and acupuncture treatments. The gain in body weight, depression and relapse are also dealt with. The various and personally tailored therapeutic strategies used in a service operating in a setting of Internal Medicine are presented and discussed.

Behavior Therapy↗

Health priorities.

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Manitoba↗

State mental health directors' priorities for mental health care.

The National Association of State Mental Health Program Directors surveyed all state mental health directors, through a series of mail questionnaires, to determine their national priorities for mental health care in the 1980s. In a ranking of 62 issues, the directors considered the top two priorities to be providing services and support programs in the community for the chronically mentally ill. Other highly ranked priorities included developing community residential programs, assuring continuation and funding of programs in a period of financial retrenchment, and developing a continuum of services for children and adolescents. A cluster analysis showed that within the overall group four different patterns of priorities emerged: issues related to certification and accreditation, to expansion of community programs both with and without a decrease in institution-based care, and to financial accountability.

Attitude of Health Personnel↗

[Priorities and regional health programs: a survey of university lecturers in general practice from Brittany].

The aim of this investigation is to determine the level of information among GP lecturers concerning regional health priorities, their representations of public health and of regional health priorities, and to describe the place they consider to be theirs within this field. The level of information on the priorities is extremely low among GPs. Their representations of public health are diverse. They claim to take part in a public health mission but this claim concerns individual rather than joint action. The legitimate vehicles of information for these professionals are primarily the continuous medical training associations and the State, ahead of the medical faculties. This raises the question of training and the involvement of GPs in public health initiatives. Research, whether action research, applied research or participation in more basic research would appear to be a good way of promoting their first steps towards joint action.

Adult↗

Setting health care priorities in Pakistan.

OBJECTIVE: To describe a health priority setting exercise in Pakistan and its relevance to traditional medical care and care providers. METHODS: Literature search of local and regional data was performed to identify priority health problems, those with high disease burden and with cost-effective interventions. RESULTS: Major causes of ill-health were communicable (diarrhoea, respiratory infections, childhood immunizable diseases, malaria, tuberculosis) and pregnancy related diseases. Factors that contributed to these disorders included malnutrition, anemia, poor sanitation and water supply, low level of education, high fertility rates and poverty. For these conditions, cost-effective interventions for prevention included environmental control (provision of clean water and sanitation), education programmes, expanded programme of immunization and family planning and those for treatment included case management of diarrhoea, respiratory infections, tuberculosis and complications of pregnancy and childbirth. CONCLUSION: Priority health problems include factors outside the domain of traditional medical care. Their definition is important for directing policy reform, medical curricula and health research.

Health Policy↗