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Adapting smoking cessation interventions for developing countries: a model for the Middle East

Authors: Maziak, W.1; Eissenberg, T.2; Klesges, R. C.3; Keil, U.1; Ward, K. D.3

Source: The International Journal of Tuberculosis and Lung Disease, Volume 8, Number 4, April 2004 , pp. 403-413(11)

Publisher: International Union Against Tuberculosis and Lung Disease

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OBJECTIVE: To describe the rationale and methods for the development of culturally-sensitive smoking cessation interventions for primary care settings in developing countries.

RATIONALE: Smokers in the Middle East have great difficulty quitting. Effective smoking cessation programs are currently lacking in the Middle East, and the development of culturally sensitive programs is hindered by the dearth of standardized information regarding tobacco use and dependence in this region.

METHODS: Epidemiological and clinical laboratory methods are needed to determine the prevalence and patterns of tobacco use and nicotine dependence. One strategy is to adapt smoking cessation methods widely used in industrialized countries to the Syrian and Middle Eastern environment. In a recently initiated project, the Syrian Center for Tobacco Studies has been established to address these issues. Initial work is focusing on collecting formative data including key informant interviews, focus groups, and epidemiological surveys to assess smokers' use patterns, needs, and resources. Clinical laboratory techniques are also being applied to assess the physiological, behavioral, and subjective effects of local tobacco use methods, such as narghile (water pipe) smoking. These data will be used to help adapt existing smoking cessation interventions from industrialized countries to be evaluated in a randomized controlled trial.

CONCLUSION: There is a great need to develop and disseminate effective cessation interventions in low-income countries. Successful interventions will contribute to a culturally sensitive and sustainable regional tobacco control infrastructure. This paper describes one approach to the development of such an infrastructure that is currently underway in the Middle East.

Keywords: Middle East; Syria; developing countries; primary care; smoking cessation

Document Type: Review Article

Affiliations: 1: Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic; and the Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany 2: Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic; and the Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA 3: Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic; and the Center for Community Health, University of Memphis, Memphis, Tennessee, USA

Publication date: April 1, 2004

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

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