scholarly journals Lessons Learned from Twelve Years of Partnered Tobacco Cessation Research in the Dominican Republic

2016 ◽  
Vol 11 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Deborah J. Ossip ◽  
Sergio Díaz ◽  
Zahira Quiñones ◽  
Scott McIntosh ◽  
Ann Dozier ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Tobacco Control ◽  
Tobacco Cessation ◽  
Early Stage ◽  
Lessons Learned ◽  
Middle Income ◽  
Health Crisis ◽  
Challenges And Opportunities ◽  
Tobacco Epidemic ◽  
The One

Engaging partners for tobacco control within low and middle income countries (LMICs) at early stages of tobacco control presents both challenges and opportunities in the global effort to avert the one billion premature tobacco caused deaths projected for this century. The Dominican Republic (DR) is one such early stage country. The current paper reports on lessons learned from 12 years of partnered United States (US)-DR tobacco cessation research conducted through two NIH trials (Proyecto Doble T, PDT1 and 2). The projects began with a grassroots approach of working with interested communities to develop and test interventions for cessation and secondhand smoke reduction that could benefit the communities, while concurrently building local capacity and providing resources, data, and models of implementation that could be used to ripple upward to expand partnerships and tobacco intervention efforts nationally. Lessons learned are discussed in four key areas: partnering for research, logistical issues in setting up the research project, disseminating and national networking, and mentoring. Effectively addressing the global tobacco epidemic will require sustained focus on supporting LMIC infrastructures for tobacco control, drawing on lessons learned across partnered trials such as those reported here, to provide feasible and innovative approaches for addressing this modifiable public health crisis.

scholarly journals Tobacco intervention research in low- and middle-income countries: lessons learned and future directions

2016 ◽  
Vol 11 (2) ◽  
pp. 61-64 ◽  
Author(s):  
Kenneth D. Ward
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Tobacco Dependence ◽  
Lessons Learned ◽  
Future Directions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Tobacco Intervention

Treating tobacco dependence is paramount for global tobacco control efforts, but is often overshadowed by other policy priorities. As stated by Jha (2009), “cessation by current smokers is the only practical way to avoid a substantial proportion of tobacco deaths worldwide before 2050.” Its importance is codified in Article 14 of the Framework Convention on Tobacco Control (FCTC), and in the WHO's MPOWER package of effective country-level policies. Unfortunately, only 15% of the world's population have access to appropriate cessation support (WHO, 2015). Moreover, parties to the FCTC have implemented only 51% of the indicators within Article 14, on average, which is far lower than many other articles (WHO, 2014). Further, commenting on the use of “O” measures (Offer help to quit tobacco use) in the MPOWER acronym, WHO recently concluded, “while there has been improvement in implementing comprehensive tobacco cessation services, this is nonetheless a most under-implemented MPOWER measure in terms of the number of countries that have fully implemented it” (WHO, 2015). To the detriment of global tobacco control efforts, only one in eight countries provides comprehensive cost-covered services, only one in four provide some cost coverage for nicotine replacement therapy, and fewer than one third provide a toll-free quit line (WHO, 2015).

scholarly journals Tobacco Cessation in Economically Disadvantaged Dominican Republic Communities: Who are the Ex-Users?

2015 ◽  
Vol 11 (4) ◽  
pp. 239-249 ◽  
Author(s):  
Deborah J. Ossip ◽  
Zahíra Quiñones ◽  
Sergio Diaz ◽  
Kelly Thevenet-Morrison ◽  
Susan Fisher ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Tobacco Use ◽  
Economically Disadvantaged ◽  
Tobacco Cessation ◽  
Effective Means ◽  
Control Measures ◽  
Vulnerable Groups ◽  
Caribbean Region ◽  
Middle Income ◽  
Health Crisis

Introduction: Tobacco use and its harm continue to increase in low and middle income countries (LMICs) globally. Smoking cessation is the most effective means of reducing morbidity and mortality from tobacco use. Increasing the prevalence of ex-users is an indicator of population cessation.Aims: This study provides the first examination of factors associated with ex-tobacco use status in the Dominican Republic (DR), a LMIC in the Latin America and Caribbean region.Methods: Baseline surveillance was conducted for 1,177 randomly selected households in seven economically disadvantaged DR communities (total N = 2,680 adult household members).Results: Ex-user prevalence was 10.6% (1.0%–18.5% across communities), 14.8% were current users (9.1–20.4), and quit ratios were 41.7% (9.7%–52.7%). Among ever users, females (OR 2.02, 95% CI 1.41, 2.90), older adults (45–64: OR 1.75, 95% CI 1.12, 2.74; 65+: OR 2.09, 95% CI 1.29, 3.39), and those who could read/write (OR 1.64, 95% CI 1.08, 2.50), had health conditions (OR 1.63, 95% CI 1.11, 2.41), and lived with ex-users (OR 1.70, 95% CI 1.12, 2.58) were over 60% to two times as likely to be ex-users. Those from remote communities (OR 0.52, 95% CI 0.36, 0.74), using chewed tobacco (OR 0.14, 95% CI 0.04, 0.48) and living with tobacco users (OR 0.55, 95% CI 0.37, 0.81) were less likely to be ex-users.Conclusions: Ex-user prevalence and quit ratios were lower than for high income countries. Implementing broad tobacco control measures, combined with clinically targeting vulnerable groups, may increase tobacco cessation to most effectively reduce this public health crisis.

scholarly journals Promoting Tobacco Cessation in Low- and Middle-Income Countries

2016 ◽  
Vol 11 (2) ◽  
pp. 66-69 ◽  
Author(s):  
Harry A. Lando
Keyword(s):  
Clinical Practice ◽  
Tobacco Cessation ◽  
High Income ◽  
Limited Resources ◽  
Public Knowledge ◽  
Middle Income ◽  
Middle Income Countries ◽  
Tobacco Epidemic ◽  
Who 2008 ◽  
Low And Middle Income

The tobacco epidemic is increasingly concentrated in low- and middle-income countries (LMICs) (WHO, 2008). These countries often have very limited resources and infrastructure to confront this epidemic. Public knowledge of tobacco health harms may be quite limited and, unfortunately, this is often true for health professionals as well (Nichter, 2006). Clinical practice guidelines have identified effective tobacco cessation interventions (Clinical Practice Guideline, 2008), but these have been focused primarily upon high-income countries. Approaches that have been successful in high-income countries may not be directly applicable in low-resource settings. Thus, for example, medications may not be readily accessible and infrastructure to support quit line programs may be minimal or non-existent.

scholarly journals The Governance of Covid-19 Pandemic Health Emergency in Italy: A Constitutional Perspective

2021 ◽  
pp. 101-109
Author(s):  
Angela Cossiri
Keyword(s):  
Early Stage ◽  
Social Solidarity ◽  
Second Phase ◽  
Constitutional Democracy ◽  
Health Crisis ◽  
Ex Post ◽  
The One ◽  
Council Of Ministers ◽  
Short Time ◽  
Italian Constitution

The essay focuses on the measures that have been taken in Italy to limit the contagion with Coronavirus in the first phase of the health emergency in 2020. The Italian Government was the first to face the epidemiological crisis in a constitutional democracy. The lockdown was one of the most drastic in Europe. On the one hand, fundamental freedoms of individuals have been compressed; on the other, the objective of limiting the expansion of the contagion in the early stage of pandemic expansion has been achieved, probably saving all European countries from an ungovernable health crisis before a minimal preparation. Even some critical aspects in the decision making process could be highlighted from a constitutional law perspective, the Author believes that the temporary measures, although drastic, not exceeded the limits allowed by the Italian Constitution, nor they seriously affected the balance between the powers at least in the first/second phase. The majority of Parliament approved ex post the law-decrees adopted by the Council of Ministers, demonstrating that it share the Government’s political position. Furthermore, in a very short time, the Italian people, in their vast majority, spontaneously adapted to the imposed prohibitions, demonstrating a sense of responsibility and solidarity towards the most vulnerable categories with respect to the effects of the virus (elderly and sick people, for example). The reasons of the economy, which would have required not to stop business activities, have been temporarily recessive with respect to the protection of the health of the community. This decision seems to find its ultimate foundation in the Article 2 of the Italian Constitution which requires everyone to respect the duty of social solidarity.

scholarly journals Tobacco-Free Investment: Harnessing the Power of the Finance Industry in Comprehensive Tobacco Control

2018 ◽  
Vol 17 (2) ◽  
pp. 161
Author(s):  
Bronwyn King ◽  
Clare Payne ◽  
Emily Stone
Keyword(s):  
Tobacco Control ◽  
Tobacco Industry ◽  
High Income ◽  
Global Finance ◽  
Middle Income ◽  
Finance Industry ◽  
Tobacco Epidemic ◽  
The 1960S ◽  
Industrialised Countries ◽  
Low And Middle Income

Leveraging the power of the global financial sector is emerging as a powerful, targeted strategy in tobacco control. The tobacco epidemic has been in decline in many high income nations since the 1960s but shows few signs of abating in low and middle income nations, with the tobacco industry offsetting regulatory restrictions and shrinking markets in industrialised countries by actively promoting tobacco use in poorer countries with weaker tobacco control. Lung cancer rates and tobacco-related mortality statistics reflect these changes with levels declining in high income countries but yet to peak in low and middle income countries. This contrast calls for new approaches that can cross borders, transcend the barriers between legislative domains and offer a truly international approach. Tobacco Free Portfolios works collaboratively with the global finance sector to inform, advance and prioritise tobacco-free investment. This initiative aims to encourage finance leaders to reflect on and reconsider commercial relationships with the tobacco industry, urging them to be part of the solution when it comes to addressing one of greatest global challenges of our time.

scholarly journals The new contraceptive revolution: developing innovative products outside of industry†,‡

2020 ◽  
Vol 103 (2) ◽  
pp. 157-166
Author(s):  
Rebecca L Callahan ◽  
Neha J Mehta ◽  
Kavita Nanda ◽  
Gregory S Kopf
Keyword(s):  
Unmet Need ◽  
Lessons Learned ◽  
Innovative Drug ◽  
Middle Income ◽  
Government Organizations ◽  
Drug Products ◽  
Technological Advances ◽  
Challenges And Opportunities ◽  
Innovative Products ◽  
Early Phase Clinical Trials

Abstract A significant global unmet need for new contraceptive options for both women and men remains due to side effect profiles, medical concerns, and inconvenience of many currently available products. The pharmaceutical industry has largely abandoned early research and development for contraception and will not likely engage to bring new products to the market unless they have been significantly de-risked by showing promise in early phase clinical trials. This lack of interest by big pharma comes at a time when scientific and technological advances in biology and medicine are creating more opportunities than ever for the development of new and innovative drug products. Novel partnerships between the academic sector, small biotechnology companies, foundations, non-government organizations (NGOs), and the federal government could accelerate the development of new contraceptive products. We discuss the challenges and opportunities that we have encountered as an NGO with a mission to develop novel contraceptive products for low- and middle-income countries and how it differs from developing products for higher-income markets. We hope that our experiences and “lessons learned” will be of value to others as they proceed down the product development path, be it for female or male or for hormonal or nonhormonal contraceptives.

Engaging People in Tobacco Prevention and Cessation: Reflecting Back Over 20 Years Since the Master Settlement Agreement

2020 ◽  
Vol 54 (12) ◽  
pp. 932-941
Author(s):  
Amanda L Graham
Keyword(s):  
Public Health ◽  
Tobacco Control ◽  
Digital Technologies ◽  
Tobacco Product ◽  
Lessons Learned ◽  
Tobacco Prevention ◽  
The Past ◽  
Widespread Adoption ◽  
Settlement Agreement ◽  
Challenges And Opportunities

Abstract Over the past 20 years, tobacco prevention and cessation efforts have evolved to keep pace with the changing tobacco product landscape and the widespread adoption of digital technologies. In 2019, Truth Initiative was awarded the Society of Behavioral Medicine’s Jessie Gruman Award for Health Engagement in recognition of the major role it has played on both fronts since its inception in 1999. This manuscript reviews the challenges and opportunities that have emerged over the past two decades, the evolving tactics deployed by Truth Initiative to engage people in tobacco prevention and cessation efforts, the approaches used to evaluate those efforts, and key achievements. It concludes with a summary of lessons learned and considerations for tobacco control researchers and practitioners to accelerate their impact on public health.

A Systematic Review of Tobacco Industry Tactics in Southeast Asia: Lessons for Other Low- And MiddleIncome Regions

2020 ◽  
Author(s):  
Gianna Gayle Herrera Amul ◽  
Grace Ping Ping Tan ◽  
Yvette van der Eijk
Keyword(s):  
Public Health ◽  
Southeast Asia ◽  
Tobacco Control ◽  
Tobacco Industry ◽  
Economic Benefits ◽  
The Philippines ◽  
Middle Income ◽  
Tobacco Marketing ◽  
Tobacco Epidemic ◽  
Transnational Tobacco Companies

Background: Transnational tobacco companies (TTCs) have a well-established presence in Southeast Asia and are now targeting other low- and middle-income countries (LMICs), especially Africa. While the tobacco industry’s tactics in Southeast Asia are well documented, no study has systematically reviewed these tactics to inform tobacco control policies and movements in Africa, where the tobacco epidemic is spreading. Methods: We conducted a systematic literature review of articles that describe tobacco industry tactics in Southeast Asia, which includes Singapore, Indonesia, Malaysia, the Philippines, Myanmar, East Timor, Thailand, Cambodia, Vietnam, Laos, and Brunei. After screening 512 articles, we gathered and analysed data from 134 articles which met our final inclusion criteria. Results: Tobacco transnationals gained dominance in Southeast Asian markets by positioning themselves as good corporate citizens with corporate social responsibility (CSR) initiatives, promoting the industry as a pillar of, and partner for, economic growth. Tobacco transnationals also formed strategic sectoral alliances and reinforced their political ties to delay the implementation of regulations and lobby for weaker tobacco control. Where governments resisted the transnationals’ attempts to enter a market, they used litigation and deceptive tactics including smuggling to pressure governments to open markets, and tarnished the reputation of public health organizations. The tobacco industry undermined tobacco advertising, promotion and sponsorship (TAPS) regulations through a broad range of direct and indirect marketing tactics. Conclusion: The experience of Southeast Asia with tobacco transnationals show that, beyond highlighting the public health benefits, underscoring the economic benefits of tobacco control might be a more compelling argument for governments in LMICs to prioritise tobacco control. Given the tobacco industry’s widespread use of litigation, LMICs need more legal support and resources to counter industry litigations. LMICs should also prioritize measures to protect health policy from the vested interests of the tobacco industry, and to close regulatory loopholes in tobacco marketing restrictions.

scholarly journals Setting Up a Horizon Scanning System: A U.S. Federal Agency Example

2018 ◽  
Vol 10 (2) ◽  
pp. 136-151 ◽  
Author(s):  
Andy Hines ◽  
David N. Bengston ◽  
Michael J. Dockry ◽  
Adam Cowart
Keyword(s):  
Early Stage ◽  
Forest Service ◽  
Lessons Learned ◽  
Scanning System ◽  
Policy Makers ◽  
Horizon Scanning ◽  
Look Ahead ◽  
Challenges And Opportunities ◽  
Near Term ◽  
Horizon Scanning System

Managers and policy makers are continually working toward a desired future within a context of rapid and turbulent change. To be effective in this context, they must look ahead to anticipate emerging trends, issues, opportunities, and threats. Horizon scanning is a foresight method that can help managers and policy makers develop and maintain a broad and externally focused forward view to anticipate and align decisions with both emerging (near-term) and long-term futures. This article reports on the design and early stage development and implementation of a horizon scanning system established for the U.S. Forest Service (USFS), Strategic Foresight Group, and developed cooperatively with the University of Houston Foresight Program. The goal of the project is to develop an ongoing horizon scanning system as an input to developing environmental foresight: insight into future environmental challenges and opportunities, and the ability to apply that insight to prepare for a sustainable future. In addition, the horizon scanning system is supported by volunteers from within the Forest Service. By including participants from throughout the Forest Service, the project seeks to foster a culture of foresight within the organization, and eventually to develop a more forward looking organizational structure for the USFS and other natural resource management agencies. Lessons learned from the experience to date are shared as well as future challenges for keeping the horizon scanning system in good working order—current, relevant, and consistent.

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