Introduction and Objectives
TB and Tobacco is coordinated by the University of York (Department of Health Sciences). It involves eight other partners: ARK Foundation, Bangladesh; HERD International Pvt. Ltd., Nepal; National TB Programme, Pakistan; The Initiative, Pakistan; Heinrich-Heine University, Düsseldorf, Germany; the University of Edinburgh, UK; the University of Leeds, UK and the General University Hospital, Prague, Czech Republic.
The overall objective of TB and Tobacco is to reduce the burden of lung disease in low- and middle-income countries (LMIC). We aim to do this by helping people with TB to stop smoking, using inexpensive strategies that have already been shown to work elsewhere. The strategies are aimed at patients who have been newly diagnosed with TB, and will be integrated into TB control programmes in our target countries. The research is focussed on three countries that have high incidence of tobacco use and high prevalence of TB; namely Bangladesh, Pakistan and Nepal.
Our study is centred round a clinical trial of a drug called cytisine, which has been evaluated in combination with behavioural support for tobacco cessation, and compared with behavioural support alone. Cytisine has been shown to be effective as a tobacco cessation medication in Eastern Europe, but until TB & Tobacco, no clinical trials had been conducted with it in LMIC.
We have assessed the effectiveness and cost-effectiveness of tobacco cessation strategies in helping TB patients to quit smoking and to improve their clinical outcomes – the effectiveness goal. We have explored how best to implement these strategies, scale them up and sustain them over the long term – the implementation goal.
By studying the ‘real world’ influences on the implementation and success of stopping smoking in these contexts, we are determined to translate the findings of the study into real benefits for patients and society.
