An understanding of women and their tobacco-related issues, as well as the need for the development of gender-relevant tobacco control efforts, have been highlighted as priorities in landmark guiding documents published in the past few years (e.g., WHO Framework Convention on Tobacco Control-WHO FCTC). Brazil is the second largest producer of tobacco in the world, and 95% of the tobacco is produced in the three Southern states (Paran?, Santa Catarina, and Rio Grande do Sul). Although, historically, tobacco use among women in developing countries, particularly Latin America, has been relatively low as compared to men, the smoking epidemic is rapidly spreading to women in developing countries, and these three Southern states have the highest prevalence of women smokers in the country. We have established a Network for Tobacco Control among Women in Paran?, Brazil with the purpose of establishing community and institutional capacity to promote gender-relevant tobacco control efforts among women through Community-Based Participatory Research (CBPR) and training. The goals of the network are to reduce tobacco use and exposure to environmental tobacco smoke (ETS) among women in Paran?, and to develop a cadre of well-trained researchers who will continue to address comprehensive tobacco control strategies at multiple levels. The network conducted an epidemiological survey on the prevalence and factors associated with tobacco use among women across the State of Paran?. Based on the results, the network identified four priorities: (1) to implement policy changes to decrease ETS;(2) to understand the health/social issues of women in tobacco farming;(3) to develop and evaluate a comprehensive, culturally- and gender relevant, school-based smoking prevention program;and (4) to improve access and delivery of smoking cessation programs through the public health system with a particular focus on "light smokers" as 74.8% of women smokers in our study reported smoking 10 or less cigarettes/day. The network is currently addressing the first three priorities, including support for legislation, which resulted in Paran? having the strongest indoor tobacco ban in the country. The overall goal of this renewal is three-fold: (1) to continue to sustain and strengthen the network;(2) to conduct a group randomized controlled trial to assess the efficacy of a theory-based, culturally- and gender- relevant Community Health Worker intervention for Brazilian women "light smokers" that will augment the smoking cessation programs offered through the public health system;and (3) to expand our current Career Development and Research Training Program to the other two major tobacco growing states in order to develop a cadre of well-trained researchers who will continue to develop and implement gender-relevant comprehensive tobacco control strategies at all levels.
There is a great need for the development of gender-relevant tobacco control efforts. We have established community and institutional capacity to promote gender-relevant tobacco control efforts among women in a tobacco producing state in Brazil - Network for Tobacco Control among Women in Paran?, Brazil. Through this renewal, we propose to 1) continue to sustain and strengthen the network, 2) conduct a group randomized controlled trial to assess the efficacy of a theory-based, culturally- and gender-relevant Community Health Worker intervention that will augment smoking cessation of Brazilian women light smokers, and 3) expand our current capacity building program to the other two major tobacco producing states in Brazil.