Smoking has long been recognized as a significant public health concern associated with great morbidity and mortality. Although smoking rates have decreased in high income countries, these trends have not been noted for tow and middle income countries. This is especially true in Turkey, which was ranked 6th in the world in smoking consumption. Between 51-63% of Turkish men and 24-26% of Turkish women 15 years of age and older are smokers. With lung cancer the leading cancer-related cause of death for both men and women, effective and accessible smoking cessation interventions are needed. Cell phone technology represents a unique opportunity to deliver evidenced-based smoking cessation behavioral treatments through a delivery mechanism already widely adopted by adults. An estimated 35 million Turks were using cell phones, making them 1.8 times more common than land lines. Cell phone interventions are a unique delivery method because of their 'always on' capability. The rapid uptake of cell phones allows us to potentially reach those who might otherwise not utilize smoking cessation services. In this response to Request for Applications (RFA-TW-06-006), we propose to design and evaluate an evidenced-based smoking intervention that takes advantage of technologies adopted by adult smokers in Turkey. Based upon STOMP (Stop smoking by Mobile Phone) New Zealand, a TXT messaging-based smoking cessation program, SMS (Smoking Management System) Turkey will be a community-based intervention that has both wide reach and high impact. To do so, we bring together a multi-national team of smoking and technology health experts dedicated to building the capacity of smoking cessation research expertise in Turkey to reduce the public health burden associated with smoking in Turkey. Using qualitative methods to inform design and content and quantitative methods to assess the feasibility and potential intervention effect, we propose to develop SMS Turkey, an innovative smoking cessation program that uses technology widely adopted by adults, an under-targeted population, to deliver a proactive, cognitive behavioral therapy (CBT)-based, theoretically grounded intervention. Simultaneously, we will build the capacity for future smoking cessation efforts in Turkey by training two medical fellows to become smoking cessation researchers, and continuing to strengthen international research ties. The high reach of cell phones allows us to potentially reach smokers who would otherwise not utilize traditional smoking cessation services, representing the possibility of a large public health impact. ? ? ?
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