BACKGROUND:

The low and middle-income countries of the world face a rising threat to public health from the rapidly escalating epidemic of tobacco use. Strong evidence based programs are urgently needed to promote tobacco control. However, few less developed countries have sufficient infrastructure or capacity for tobacco control research, and funding for such research may be unavailable or extremely limited. This study builds on the strong partnerships already established by the Institute for Global Tobacco Control of the Bloomberg School of Public Health and sets out a strategy for enhanced tobacco control research and capacity building in Asia and Latin America.

The study is in response to a Request for Applications titled "International Tobacco and Health Research and Capacity Building Program" released jointly in June, 2001 by the Fogarty International Center, the National Cancer Institute, the National Institute of Child Health and Human Development, the National Institute of Mental Health, the National Institute of Nursing Research, and the National Institute of Drug Abuse.

DESIGN NARRATIVE:

The core elements of the program will include in-depth training of tobacco control leaders in the regions, regional training and policy relevant epidemiologic and intervention research. Established researchers will receive in-depth training at the Johns Hopkins Bloomberg School of Public Health to equip them not only with needed research competencies but also with an understanding of the relationship between tobacco control evidence and effective policy. Regional training workshops will focus on key regional needs and help to establish a network of tobacco control experts within and between countries who can develop and implement collaborative research projects. Research needs will be established through interactions with stakeholder groups and policy makers in each region. For the initial year, research projects are proposed based on research needs identified as policy relevant through prior collaborations. In Brazil, a national survey in 9,000 residents of tobacco use and tobacco related knowledge, attitudes and behavior is proposed in collaboration with the National Cancer Institute. In China, the proposed research effort is a community intervention trial in 800 families, focusing on the creation of smoke free homes with the Chinese Academy of Preventive Medicine. In Mexico, the Institute plans to work with its partner, the National Institute for Public Health, to estimate smoking attributable morbidity and mortality, and associated costs in 1,200 cases and controls.