Tobacco control without cessation? Policy gaps in cessation services in Bangladesh

Tobacco use is a leading contributor to the burden of non-communicable diseases (NCDs) in Bangladesh. Although the country has implemented a series of tobacco control measures over the past two decades, the integration of tobacco cessation services into the public healthcare system has received limited attention. This short communication aimed to examine policy and health system gaps affecting the provision of cessation services in Bangladesh's public healthcare facilities and identify priorities for strengthening cessation support.

This short communication was based on a review of national health policy documents.

Key national health policies and strategic frameworks, including the National Health Policy 2011, the 3rd HPNSDP, the 4th HPNSP, the 5th HPNSP, the Operational Plans of the 3rd HPNSDP and the 4th HPNSP, and the Multisectoral Action Plan for Prevention and Control of Non-communicable Diseases (2018-2025) were reviewed to identify policy and implementation gaps related to tobacco cessation services.

The reviewed health policies consistently recognise tobacco use as an important risk factor for NCDs and emphasise population-level tobacco control measures. Although some policy documents outline tobacco cessation initiatives such as a national tobacco quitline and community-based smoking cessation counselling, they lack a comprehensive operational framework for integrating tobacco cessation into routine healthcare services. Key health system gaps include the absence of standardised clinical protocols, clearly defined provider responsibilities and referral pathways, limited access to pharmacotherapy, and inadequate provider training.

Despite substantial progress in tobacco control, tobacco dependence treatment remains insufficiently integrated into Bangladesh's public healthcare system. Strengthening tobacco cessation will require integrating cessation services into routine primary healthcare and NCD services, developing national clinical guidelines and implementation frameworks, expanding access to behavioural and pharmacological interventions, building the capacity of the health workforce, and establishing sustainable financing mechanisms.