DESCRIPTION (provided by applicant): Tobacco cessation is a global health priority not yet addressed in low and low-middle income countries such as India and Indonesia. An important lesson gleaned from international health is that interventions proven effective in western countries cannot simply be exported to developing nations without significant cultural adaptation. Research is urgently needed to find the most effective means of promoting cessation in local contexts. A first step in gaining public attention about the harm of tobacco use and the need for cessation is to involve the medical community in tobacco cessation efforts. It has been well established that before tobacco use declines in the general population, health care providers must be at the forefront of tobacco cessation efforts. To do so, they must quit tobacco use themselves, routinely ask patients about tobacco use, and advise them to quit. At present, there is little involvement of physicians in tobacco cessation efforts in India and Indonesia. Based on four years of experience during Project Quit Tobacco International (QTI) (under the previous Fogarty initiative), the proposed project unfolds as a four-step process to develop a cohort of tobacco cessation researchers in India and Indonesia, using local medical schools as a hub for research activities in both the health care community and the community at large. Medical schools will become centers for recruiting and training tobacco cessation researchers as well as sites for implementing pilot studies and mobilizing local tobacco cessation research networks. The specific objectives of the project are to (1) increase knowledge about the risks of tobacco use and the importance of cessation through dissemination of a model tobacco education curriculum for medical schools in India and Indonesia; (2) recruit and train tobacco researchers concurrently with introducing tobacco education in nine medical schools in each country; (3) involve partner medical schools in tobacco cessation-related community-based research pilot studies, and (4) build capacity in tobacco-related research in both countries by creating tobacco cessation research networks in the six states (three in each country) where project activities will take place. Developed over the past four years, the QTI tobacco cessation research centers in India and Indonesia have begun to engage the communities in which they are located. In-country researchers have gained the skills and confidence to take the next step toward building research capacity beyond their institutions in these two culturally diverse nations. The proposed project will leverage lessons learned during QTI and provide an infrastructure for training a next generation of local tobacco researchers to meet the challenges of tobacco cessation within their own countries.
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