Infrastructure of tobacco and nicotine cessation services in Finnish healthcare: A cross-sectional study.

INTRODUCTION

Many countries have made significant progress in implementing effective tobacco control policies. Despite the availability of clinical treatment guidelines for smoking cessation, their integration into routine healthcare systems is less well-known. In Finland, recommendations addressing the infrastructure of tobacco and nicotine cessation, aimed at healthcare service providers, were published in 2024. This study aims to provide a baseline assessment for their evaluation.

METHODS

This cross-sectional study collected data in autumn 2024 from twenty-one wellbeing service counties (88%) using an online survey directed at professionals working in healthcare services involved in tobacco and nicotine-related care, including smoking cessation counseling, early identification, and brief interventions. Data were analyzed using descriptive statistics. HHS Framework to Support and Accelerate Smoking Cessation 2024 was utilized to provide a conceptual framework for interpreting the findings.

RESULTS

Established structures for cessation services were limited; only 29% (6/21) of counties had appointed a dedicated entity, and 33% (7/21) provided annual training for healthcare professionals in tobacco cessation. Documentation of tobacco and nicotine use in medical records was the most successfully implemented component, reported by 81% (17/21) of counties, followed by the provision of digital services, 71% (15/21). The system includes features for structural documentation, with 62% (13/21) of counties recording early identification and brief interventions in medical records. Cessation services were communicated through multiple channels, including websites, social media, and healthcare centers.

CONCLUSIONS

There is a significant variation in the structure and organization of tobacco and nicotine cessation services across wellbeing service counties, with many still in the early stages of development. While documentation of tobacco and nicotine use among patients has been increasingly adopted, the implementation of key components such as early identification, brief interventions, and cessation support remains underemphasized. Strengthening institutional support, organizational structures, professional training, communication, and information flow are associated with more effective implementation.