Tobacco Control Capacity Research Articles

Tobacco endgame in the WHO European Region: Feasibility in light of current tobacco control status.

To assess the feasibility of developing World Health Organization (WHO) European Region countries' goals and measures in line with tobacco endgame objectives, information on the current tobacco control context and capacity is needed. The aim of this study was to assess the implementation of the Framework Convention on Tobacco Control (WHO FCTC) and MPOWER measures in the region. In this cross-sectional study we used data from the WHO FCTC implementation reports and MPOWER from 2020 in 53 WHO European Region countries. Six domains (i.e. capacity, taxation and price policies, other national key regulations, public awareness raising and communication, tobacco use cessation, and monitoring) were formed. Subsequently, available indicators under these domains were scored and the level of implementation was computed for each country. Mann-Whitney tests were carried out to compare the scores between the group of countries with and without official endgame goals. Overall, implementation of the WHO FCTC with the selected indicators at the country level ranged from 28% to 86%, and of MPOWER from 31% to 96%. Full implementation was achieved by 28% of WHO FCTC Parties in the region in taxation and price policies, 12% in public awareness raising and communication, and 42% in monitoring. In capacity, tobacco use cessation and other national key regulations, none of the Parties in the region reached full implementation. Overall median WHO FCTC scores were significantly higher in countries with official endgame goals than in those without (p<0.001). There is unequal implementation of both WHO FCTC and MPOWER measures among WHO European Region countries. MPOWER and WHO FCTC provide all the measures for the necessary first steps, followed by innovative measures, to accomplish tobacco endgame goals.

The Analysis of the Content of Tobacco Control Policymaking and Legislation in Iran and Providing Policy Solutions

Background. Tobacco use is the fifth risk factor for non-communicable diseases in Iran. This study aimed to analyze the policies and measures of tobacco control in Iran in the last four decades (1983-2021). Methods. The present study is a retrospective policy analysis that used a case study plan based on the Walt and Gilson triangle policy analysis framework to examine the content of tobacco control policies in Iran. Data were collected using tobacco use policies and legal documents and analyzed using documentary analysis. MAXQDA 11 software was used to categorize and analyze the findings. Results. The policies include setting prices and taxes on tobacco to reduce demand; protecting the public from second-hand smoke; controlling the composition of tobacco products; setting regulations on the disclosure of information about tobacco packaging and labeling; educating the public about the dangers of tobacco use; advertising, promotion, and financial support of tobacco; setting measures to encourage smoking cessation and reduce the demand and dependence on tobacco; banning illegal tobacco product trading; banning youngsters from tobacco trading; financially supporting the practical alternatives such as economic activities and research; setting monitoring and evaluation systems; and enhancing the exchange of information. Conclusion. Strengthening the government's tobacco control capacity and formulating a clear and coherent national tobacco control strategy and roadmap, including a mechanism for practical cross-sectoral cooperation between different actors, can reduce conflicts of interest between the actors involved and determine the country's current and future tobacco control policies.

Advancing tobacco control research in Ghana: findings from a meeting with key stakeholders

Prevalence of non-communicable diseases (NCDs) is growing globally, with the greatest increase in NCD deaths expected to occur in sub-Saharan Africa (SSA) over the next five to 15 years. Tobacco use is implicated in all leading NCDs, and is one of the biggest global public health threats. Despite the projected increase in tobacco-related NCD deaths in low- and Middle-income countries (LMICs), research on tobacco control policy and implementation in SSA and more specifically, Ghana, is a low priority. To address these challenges, the School of Public Health (KNUST, Ghana) with support from the Tobacco Control Capacity Program (TCCP) funded by the Global Challenges Research Fund (GCRF) organized a 1-day stakeholder’s meeting to discuss the advancement of tobacco control research in Ghana. The aim was to propose the way forward for strengthening applied research that can inform the development of health policies and programs focused on tobacco control. Participants were drawn from academia, research and health institutions, civil society and non-governmental organisations. In this meeting overview, we present the key themes that emerged from the meeting and some strategies for advancing tobacco control research in Ghana and beyond. Directions for future research agenda include building institutional research capacity, strengthening stakeholder and public engagement on tobacco control, need for more local and comprehensive data and research, improve sustainable funding of comprehensive programs on tobacco control in Ghana and social and behavior change communication on tobacco use.

Needs of LMIC-based tobacco control advocates to counter tobacco industry policy interference: insights from semi-structured interviews

IntroductionAdvocacy is vital for advancing tobacco control and there has been considerable investment in this area. While much is known about tobacco industry interference (TII), there is little research on...

Building capacity for applied research to reduce tobacco-related harm in low- and middle-income countries: the Tobacco Control Capacity Programme (TCCP).

Tobacco use is the leading cause of preventable deaths in the world. By 2030, more than 80% of these tobacco-related deaths will occur in low- and middle-income countries (LMICs). The aim of the Tobacco Control Capacity Programme (TCCP) therefore, is to reduce tobacco-related mortality and morbidity by building research capacity in LMICs. A consortium of fifteen partner organisations across eight countries (Bangladesh, Ethiopia, Ghana, India, South Africa, the Gambia, Uganda and the UK) will offer extensive research methods and leadership training opportunities to conduct high quality research projects on policy and practice and establish strong research partnerships. An example of one such study using a mixed method design to investigate tobacco industry interference in Uganda is presented. The TCCP programme will produce research that can inform policies and practice within countries to prevent or reduce tobacco use. By conducting research in three key areas (tobacco taxation, reducing illicit trade, and addressing tobacco industry interference, as well as other local priorities) the programme will help to reduce tobacco disease and death and also generate revenue for governments through taxation which aids other development priorities. While conducting research in LMICs on these themes TCCP will provide evidence to support better implementation of the Framework Convention for Tobacco Controls (FCTC), which will result in reductions in tobacco-related mortality and morbidity and also help generate revenue for governments through taxation which aids other development priorities. The TCCP programme will create a cohort of skilled early-career researchers and research leaders who will build cohesive and successful research teams in LMICs. It will also create several collaborative networks of researchers, policy-makers and advocates to co-produce context-specific research on tobacco control and its translation into policy. This will advance implementation science in LMICs and improve population health. By generating context-specific evidence, the TCCP will support advocacy efforts to shift attitudes within communities and governments towards a stronger tobacco control. Policy makers will be assisted by the evidence generated in this programme to challenge aggressive tobacco industry tactics and implement effective tobacco control.

Development of an online webcast to build tobacco control capacity of nurses in Japanese clinical cancer centers

Development of an online webcast to build tobacco control capacity of nurses in Japanese clinical cancer centers

Building capacity for applied research to reduce tobacco-related harm in low- and middle-income countries: the Tobacco Control Capacity Programme (TCCP)

Building capacity for applied research to reduce tobacco-related harm in low- and middle-income countries: the Tobacco Control Capacity Programme (TCCP)

International collaboration to build tobacco control capacity: a case study of KOMPLY from the World Heart Federation Emerging Leaders program

International collaboration to build tobacco control capacity: a case study of KOMPLY from the World Heart Federation Emerging Leaders program

Continuing to lift the burden: using a continuous quality improvement approach to advance Aboriginal tobacco resistance and control.

Smoking remains the most preventable cause of early mortality and ill health in Aboriginal people. The Aboriginal Health & Medical Research Council of New South Wales has developed the Aboriginal Tobacco Resistance and Control (ATRAC) Yarning Tool with a range of key stakeholders, to contribute to reducing the prevalence of smoking in Aboriginal communities. The Yarning Tool was adapted from the ATRAC Framework and aims to promote the meaningful discussion, planning and strengthening of tobacco resistance and control activities using a continuous quality improvement (CQI) approach. CQI provides an opportunity to closer align current health service practice with evidence. The Yarning Tool was piloted using focus group testing across four Aboriginal Community Controlled Health Services (ACCHSs) and three Local Health Districts. Purposive sampling was used to ensure that services engaged were from a diverse range of settings, with representation from metropolitan, regional and rural areas, and services with varying degrees of tobacco control capacity. Overall, feedback on the Yarning Tool and its potential use was positive. Pilot participants consistently reported that the Yarning Tool brought staff from a range of positions together to focus on tackling tobacco for the service and community. The pilot participants agreed that the Yarning Tool could be practical for the planning and reviewing stages of a CQI activity, and recommended that the tool should be completed every 6 months. The Yarning Tool is a simple tool to guide the ATRAC Framework principles into practice, and provides a platform to support Aboriginal community-led efforts, and coordination and integration of tobacco control efforts. The tool shows promise as a mechanism to encourage ACCHSs and other relevant services to use a CQI approach to reduce tobacco use in Aboriginal communities.

Research on health education curriculum's improving the effectiveness of preventive medical students' tobacco control based on tobacco control project

Objective To explore the tobacco control project based health education curriculum reform's effect of improving medical students' tobacco control. Method Choosing the students of two classes of students in preventive medicine specialty of Harbin Medical University as the research object, investigating the students respectively with the questionnaire prepared uniformly by 7 schools before and after the course. All data were coded by Epidata 3.0, and SPSS 18.0 was used to carry out the relevant information for the chi square test and t test. Result The sample size of baseline survey was114 and after the intervention was 87. The knowledge pass rate of the girls before and after the intervention were 87.3% (48/55) and 98.2% (54/55) respectively (P=0.000). The boys' awareness rate of the secondhand smoke safety level were 13.6% (8/59) and 21.9% (7/32) respectively, and the girls were 13.0% (7/55) and 31.5% (17/55) (P=0.021). Students interested in tobacco increased from 79.8% (91/114) before intervention to 90.8% (79/87) after intervention (P=0.033). Students willing to work in the tobacco related increased from 52.2%(59/114) before intervention to 66.7% (58/87) after intervention(P=0.044). The girl who replied after intervention I am not smoking now, but won't smoke either when working in the disease control in the future reached as high as 96.4% (53/55 ), but the students were lack of confidence to help people to stop smoking. Conclusion The reform of social practice activity curriculum designed for tobacco control project is effective, and it is urgent to strengthen the training of preventive medical students' smoking cessation skills and enhance their confidence. Key words: Tobacco control; Health education curriculum; Tobacco control capacity; Preventive medical students; Questionnaire method

Strengthening government tobacco control in low- and middle-income countries: a ‘must do’ for lung health progress [Perspective

Tobacco control in low- and middle-income countries (LMICs) must gather pace in the coming decade to reverse the increasing prevalence of tobacco use and counter the intensive development of LMIC markets by the tobacco industry. If unchecked, this could undermine wider developments and gains in lung health, for example for people with tuberculosis (TB), TB and human immunodeficiency virus co-infection, asthma and chronic obstructive pulmonary disease. The issue of sustainability for tobacco control in LMICs is also pressing. This perspective article proposes that greater engagement with governments at the national and sub-national levels to strengthen their capacity for effective tobacco control, scale up action and sustain tobacco control is critical. There is also considerable scope to widen effort and impact by building tobacco control into broader initiatives, particularly into those relating to lung health. This paper draws on examples from the tobacco control technical support and capacity building in LMICs of the International Union Against Tuberculosis and Lung Disease, outlines the rationale for such an approach and addresses perceived disadvantages, limitations and barriers. Priority actions and suggestions for how these can best be applied in practice are proposed.

Building capacity for implementation of the framework convention for tobacco control in Vietnam: lessons for developing countries

Effective implementation of the WHO international Framework Convention on Tobacco Control (FCTC) is the key to controlling the tobacco epidemic. Within countries, strong national tobacco control capacity is the primary determinant for successful implementation of the FCTC. This case study of tobacco control policy describes the experience of building national tobacco control capacity in Vietnam under the Reduce Smoking in Vietnam Partnership project within a national capacity-building framework. In the Vietnam experience, four components of tobacco control capacity emerged as especially important to achieve ‘quality’ outputs and measurable outcomes at the implementation level: (i) organizational structure/infrastructure; (ii) leadership and expertise; (iii) partnerships and networks and (iv) data and evidence from research. The experience gained in this project helps in adapting our tobacco control capacity-building model, and the lessons that emerged from this country case study can provide guidance to global funders, tobacco control technical assistance providers and nations as governments endeavor to meet their commitment to the FCTC.

Evaluation on problem-based social practice improving preventive medicine students' tobacco control capacity

Problem-based social practice is organically combined with health education lessons,to improve tobacco control capacity of preventive medicine students,through study in class and social practice after class.The students' awareness rate of tobacco regulations,support rate of smoke-free school,rejecting smoking rate,and lifetime non-smokers rate have significantly increased ( 40％～90％ ) after intervention.The teaching method is adult learning model,and it has effectively enhanced preventive medical students' tobacco control capacity. Key words: Preventive medical students; Tobacco control capacity; Social practice; Problem-based learning

Changes in smoking prevalence among U.S. adults by state and region: Estimates from the Tobacco Use Supplement to the Current Population Survey, 1992-2007.

BackgroundTobacco control policies at the state level have been a critical impetus for reduction in smoking prevalence. We examine the association between recent changes in smoking prevalence and state-specific tobacco control policies and activities in the entire U.S.MethodsWe analyzed the 1992-93, 1998-99, and 2006-07 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) by state and two indices of state tobacco control policies or activities [initial outcome index (IOI) and the strength of tobacco control (SOTC) index] measured in 1998-1999. The IOI reflects cigarette excise taxes and indoor air legislation, whereas the SOTC reflects tobacco control program resources and capacity. Pearson Correlation coefficient between the proportionate change in smoking prevalence from 1992-93 to 2006-07 and indices of tobacco control activities or programs was the main outcome measure.ResultsSmoking prevalence decreased from 1992-93 to 2006-07 in both men and women in all states except Wyoming, where no reduction was observed among men, and only a 6.9% relative reduction among women. The percentage reductions in smoking in men and women respectively were the largest in the West (average decrease of 28.5% and 33.3%) and the smallest in the Midwest (18.6% and 20.3%), although there were notable exceptions to this pattern. The decline in smoking prevalence by state was correlated with the state's IOI in both women and men (r = -0.49, p < 0.001; r = -0.31, p = 0.03; respectively) and with state's SOTC index in women(r = -0.30, p = 0.03 0), but not men (r = -0.21, p = 0.14).ConclusionState level policies on cigarette excise taxes and indoor air legislation correlate strongly with reductions in smoking prevalence since 1992. Strengthening and systematically implementing these policies could greatly accelerate further reductions in smoking.

Strength of Tobacco Control in Rural Communities

This study aimed to: (a) describe the Strength of Tobacco Control (SoTC) capacity, efforts and resources in rural communities, and (b) examine the relationships between SoTC scores and sociodemographic, political, and health-ranking variables. Data were collected during the baseline preintervention phase of a community-based randomized, controlled trial. Rural counties were selected using stratified random sampling (n = 39). Key informant interviews were employed. The SoTC, originally developed and tested with states, was adapted to a county-level measure assessing capacity, efforts, and resources. Univariate analysis and bivariate correlations assessed the SoTC total score and construct scores, as well as their relationships. Multiple regression examined the relationships of county-level sociodemographic, political, and health-ranking variables with SoTC total and construct scores. County population size was positively correlated with capacity (r = 0.44; P < .01), efforts (r = 0.54; P= .01), and SoTC total score (r = 0.51; P < .01). Communities with more resources for tobacco control had better overall county health rankings (r = .43; P < .01). With population size, percent Caucasian, tobacco production, and smoking prevalence as potential predictors of SoTC total score, only population size was significant. SoTC scores may be useful in determining local tobacco control efforts and appropriate planning for additional public health interventions and resources. Larger rural communities were more likely to have strong tobacco control programs than smaller communities. Smaller rural communities may need to be targeted for training and technical assistance. Leadership development and allocation of resources are needed in all rural communities to address disparities in tobacco use and tobacco control policies.

Using Technical Assistance to Strengthen Tobacco Control Capacity: Evaluation Findings from the Tobacco Technical Assistance Consortium

Immediately following the Master Settlement Agreement of 1998 and the corresponding growth of new and existing tobacco control programs, it became clear that tobacco prevention and control organizations required technical assistance to help them carry out their missions. The Tobacco Technical Assistance Consortium (TTAC) was established at the Rollins School of Public Health in 2001 to provide tailored technical assistance services to meet the needs of the expanded workforce and to build tobacco control capacity. To understand whether and how TTAC's technical assistance enhanced capacity, TTAC conducted an evaluation of its services through semi-structured telephone interviews with the primary contacts and one to two additional informants for each of 48 technical assistance services provided over an 18-month period. The majority of respondents reported they had increased knowledge and skills in tobacco control, strengthened leadership skills, developed or strengthened partnerships with other tobacco control organizations, and changed the way they practice tobacco control following the assistance. More modest improvements were noted in the areas of increased organizational support and policy change at the local or state level.

Achieving the Framework Convention on Tobacco Control’s potential by investing in national capacity

May 2003 marked a critical achievement in efforts to stem the global tobacco epidemic, as the member states of the World Health Organization unanimously endorsed the Framework Convention on Tobacco...

Moving East: how the transnational tobacco industry gained entry to the emerging markets of the former Soviet Union—part II: an overview of priorities and tactics used to establish a manufacturing presence

Objectives: To explore how British American Tobacco (BAT), having established cigarette imports, responded to the opportunities for investment in cigarette manufacturing in the former Soviet Union (FSU). Design: Analysis of...

Evaluation of the American Stop Smoking Intervention Study (ASSIST): A Report of Outcomes

The National Cancer Institute funded an 8-year, nonrandomized demonstration project for tobacco prevention and control, the American Stop Smoking Intervention Study (ASSIST). To evaluate ASSIST, we compared changes in adult smoking prevalence, per capita cigarette consumption, and tobacco control policies between the 17 ASSIST states and the 33 non-ASSIST states and the District of Columbia. The strength of tobacco control index was used to measure state-level program elements directed at tobacco control, and the initial outcomes index (IOI) was used to measure states' tobacco control policy outcomes. Prevalence data were obtained from the Tobacco Use Supplement to the Current Population Survey, and consumption data were obtained from the Tobacco Institute's bimonthly sales figures for cigarette packs moved from wholesale warehouses. Two-stage regression and mixed-effects linear modeling were used to analyze the various outcomes. Statistical analyses for testing individual regression coefficients were one-sided. ASSIST states had a greater decrease in adult smoking prevalence than non-ASSIST states, with an adjusted difference of -0.63% (P =.049). Per capita cigarette consumption was not statistically significantly different between ASSIST and non-ASSIST states. However, an increase in the IOI of a state from the 25th to the 75th percentile was associated with a reduction in per capita cigarette consumption by 0.57 packs per person per month. State IOI was also inversely, albeit not statistically significantly, associated with smoking prevalence (regression coefficient = -0.11;P =.06). The reduction in adult smoking prevalence associated with ASSIST could have translated into approximately 278 700 fewer smokers nationwide if all states had implemented ASSIST. Investment in building state-level tobacco control capacity and promoting changes in tobacco control policies are effective strategies for reducing tobacco use.