Integrating evidence-based tobacco control services into tuberculosis control in Armenia

There is a strong epidemiological evidence of a possible causal association between tobacco use and tuberculosis (TB). It is critical to facilitate the implementation of tobacco control activities as an integral part of TB case management interventions. The goal of the proposed project is to design, implement and evaluate an advocacy and training program for integrating tobacco control measures into tuberculosis care in Armenia, a country in transition with high smoking and tuberculosis burden.

The goal of the project will be achieved through establishment of a nationwide healthcare professional partnership between the National TB Control Center and the National Tobacco Control Program; development of capacity for enforcing a policy of smoke-free environments, and building smoking cessation capacity among TB healthcare providers in Armenia. Smoking cessation capacity of TB inpatient and outpatient healthcare providers will be increased through trainings on patient counseling and treatment of tobacco dependence. The training package will be developed mainly based on the newly adapted tobacco dependence treatment guideline for TB patients.

The research team will employ a non-experimental pre-test/post test design to assess the change in physicians’ performance and patient-related outcomes. Physician smoking cessation counseling practices will be assessed according to the set of recommended behaviors of 5A model:  Ask, Advise, Asses, Assist, and Arrange follow-up. Data for the pre-intervention and post-intervention assessments of the project will be collected through surveys, focus group discussions, and in-depth interviews with TB patients, physicians, nurses, and policy makers, as well as medical chart reviews and site visits.