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Building Capacity for Global Tobacco Treatment: International Frontline Provider Perspectives

Published online by Cambridge University Press:  27 June 2018

Henrique P. Gomide ,
Kimber P. Richter ,
Erica Cruvinel ,
Leonardo Fernandes Martins  and
The International Relations Committee of ATTUD
Henrique P. Gomide
Affiliation:
Department of Psychology, Federal University of Juiz de Fora, Minas Gerais, Brazil Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas
Kimber P. Richter*
Affiliation:
Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas University of Kansas Cancer Center, Kansas City, Kansas
Erica Cruvinel
Affiliation:
Department of Psychology, Federal University of Juiz de Fora, Minas Gerais, Brazil
Leonardo Fernandes Martins
Affiliation:
Department of Psychology, Federal University of Juiz de Fora, Minas Gerais, Brazil
The International Relations Committee of ATTUD
Affiliation:
Association for the Treatment of Tobacco Dependence
*
Address for correspondence: Kimber P Richter, PhD, MPH, Department of Preventive Medicine and Public Health, University of Kansas Medical Center Mailstop 1008, 3901 Rainbow Blvd., Kansas City, KS 66160. Email: krichter@kumc.edu
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Abstract

Introduction: Many countries are enacting tobacco treatment training, guidelines and policies in order to fulfil Framework Convention on Tobacco Control (FCTC) treaty agreements. This study tapped the perspectives of international treatment providers to identify challenges and recommendations for improvement.

Methods: The cross-sectional survey included closed- and open-ended items. Distribution included professional listservs (ATTUD; Global Bridges; ENSH Global) and word-of-mouth. The survey collected data using an open-source platform (Enketo Smart Paper/Ona). We used R for quantitative analysis and Google Sheets to categorize open-ended responses.

Results: There were 155 respondents from 49 countries. Most (78.6%) provided direct services. Almost half (48.1%) reported receiving less than 6 hours of tobacco treatment training; respondents from low and lower-middle income countries (LMICs) received significantly less training (Fisher's p < 0.014). Likewise, among all respondents, 43% rated poor access to treatment; this rose to 100% among LMICs (Fisher's p < 0.001). To improve treatment and training, respondents suggested increasing government funding for pharmacotherapy and behavioural services; providing training in local languages and in the treatment of smokeless tobacco forms; trainee certification and access to online support for providers.

Conclusions: Globally, half of front-line treatment providers reported having poor access to training; this was true for all providers in LMICs and most in upper middle-income countries. Existing online trainings, available mainly in English, could be migrated to open-access formats to permit countries to tailor them to their local needs and languages. Countries in geographical proximity or historical linguistic/political alliances could forge cross-country mentoring relationships and mutual support for training.

Type
Original Articles
Information
Journal of Smoking Cessation , Volume 14 , Issue 2 , June 2019 , pp. 88 - 94
Copyright
Copyright © The Author(s) 2018 

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