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.

National Institute of Health (NIH)
Fogarty International Center (FIC)
Research Project (R01)
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Special Emphasis Panel (ZCA1-SRRB-Y (M1))
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Liu, Xingzhu
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University of Arizona
Social Sciences
Schools of Arts and Sciences
United States
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Nichter, Mark; Padmawati, Siwi; Ng, Nawi (2016) Introducing smoking cessation to Indonesian males treated for tuberculosis: The challenges of low-moderate level smoking. Soc Sci Med 152:70-9
Yamini, T R; Nichter, Mark; Nichter, Mimi et al. (2015) Developing a fully integrated tobacco curriculum in medical colleges in India. BMC Med Educ 15:90
Nichter, Mimi; Padmajam, Sreedevi; Nichter, Mark et al. (2015) Developing a smoke free homes initiative in Kerala, India. BMC Public Health 15:480
Prabandari, Yayi Suryo; Nichter, Mark; Nichter, Mimi et al. (2015) Laying the groundwork for Tobacco Cessation Education in Medical Colleges in Indonesia. Educ Health (Abingdon) 28:169-75
Nichter, Mark; Nichter, Mimi; Muramoto, Myra et al. (2010) Project Quit Tobacco International: laying the groundwork for tobacco cessation in low- and middle-income countries. Asia Pac J Public Health 22:181S-188S
Ng, Nawi; Nichter, Mark; Padmawati, Retna Siwi et al. (2010) Bringing smoking cessation to diabetes clinics in Indonesia. Chronic Illn 6:125-35
Sharma, I; Sarma, P S; Thankappan, K R (2010) Awareness, attitude and perceived barriers regarding implementation of the Cigarettes and Other Tobacco Products Act in Assam, India. Indian J Cancer 47 Suppl 1:63-8
Nichter, Mimi; Nichter, Mark; Padmawati, Retna Siwi et al. (2010) Developing a smoke free household initiative: an Indonesian case study. Acta Obstet Gynecol Scand 89:578-81
Nichter, Mimi; Padmawati, S; Danardono, M et al. (2009) Reading culture from tobacco advertisements in Indonesia. Tob Control 18:98-107
Padmawati, Retna Siwi; Ng, Nawi; Prabandari, Yayi Suryo et al. (2009) Smoking among diabetes patients in Yogyakarta, Indonesia: cessation efforts are urgently needed. Trop Med Int Health 14:412-9