The globalization of the tobacco epidemic, with particular increases in use in low and middle income countries, points to the need for research partnering between investigators from high income countries with well-developed tobacco research programs and their counterparts in low and middle income countries. The proposed project is designed to establish and evaluate tobacco awareness and cessation activities and to build research capacity in the Dominican Republic (DR) using the existing infrastructure of high technology LINCOS containers currently established in sites around the country. Harnessing existing technology to bring culturally appropriate tobacco interventions to both rural and urban dwellers, and to populations with a range of education, knowledge, and literacy skills, can bring tobacco control activities into the 21st century in a way that is replicable, maintainable, and translatable globally. The DR is an ideal site for this project, as it has among the highest smoking rates in the region with little evidence of systematic tobacco control procedures in place, and is the most advanced in its use of the LINCOS containers so can serve as a beach head for replication of effective tobacco intervention models to other low and middle income countries that will be adopting the LINCOS technologies globally. The proposed project will establish international and local professional and community working groups to guide the development of interventions targeting adult tobacco users in 6 communities in the DR. Interventions will include LINCOS-based video and easily navigable interactive web-based awareness-raising and cessation programs, with referral from healthcare providers trained in brief tobacco use screening and counseling, and from direct community awareness-raising programs. A methods development trial will randomize six communities to intervention or delayed intervention control conditions. Infrastructures for tobacco use and tobacco-related disease monitoring will be developed with local partners.
