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COMDISHSD

CANBEHAVIOURCHANGE
SUPPORTREDUCE
TOBACCOUSEINNEPAL?
Nepalhasthehighestratesoftobaccouse
inSouthAsia.Thismakestobaccousea
majorpublichealthconcern.Forpeople
withTBorlungproblems,therisksare
evengreater.Ourstudyinvolvedworking
withhealthcareworkersandsmokersto
developandtestabehaviourchange
packagethatnotonlyhelpedsmokersto
successfullyquit,butwasacceptableand
feasibleforhealthcareworkerstouseand
couldbeintegratedintoroutineprimary
healthcareservicesinNepal.

Cigarettesmokers

30%

9%

Othertobacco(egchewing)

Overallwefoundthatbehaviour
changeinterventionsdeliveredin
primarycaresettingscanbe
effective:37%ofsmokersinour
studywereabletoquitfollowingthe
intervention.

38%

6%

However,thereareimportantlessons
tolearnandsharearoundtailoring
materialstothelocalcontextand
trainingandsupportinghealthcare
workerstodelivertheintervention.

37

of smokers who received the


behaviour change support
intervention were able to quit
% smoking
(verifiedat3monthsaftertheintervention)

5 LESSONS TO SHARE FROM OUR RESEARCH


Integratingtobacco
cessationintoroutineTB
carecanhaveimportant
benefits.Anxietyabouttheir
healthandfrequentcontact
withhealthcareproviders
canresultinhigherquit
successratesamongTB
patientsthangeneral
smokers.Integrating
cessationsupportinto
existingservicescanalso
bemorecosteffectivein
lowincomecountries.
Behavioursupport
materialsshouldbetailored
tothelocalcontext.Stigma
attachedtowomen
smokersinNepalmean
theyoftenhidetheir
smoking.Werevisedour
materialsaccordinglyto
showpicturesofwomen
tobaccousersreinforcing
theideathatthebehaviour
supportpackagewasfor
menANDwomen.
Adequatetrainingand
ongoingsupportforthe

healthcareworkers
deliveringbehavioursupport
areessential.Basic
behaviourchangeskills,eg
reflectivelisteningand
tailoringadviceaccordingly
taketimetoacquire.We
foundamoveawayfrom
didacticclassroomstyle
trainingtowardsinteractive
roleplaytobehelpful.
Widespreadrespectfor
doctorsinNepalmeansthat
briefinitialsmokingcessation
advicefromthemcan
improvethepatient's
willingnesstoengageinthe
longertermbehaviour
supportprogramme.
Asupportivepolitical
environmentandaclear
governmentmandatearekey
factorsforthesmooth
implementationofsmoking
cessationinterventions,eg
theinclusionofsmoking
cessationindicatorsinthe
mainoutpatientregister.
Clickhereforourfullstudy

Clickhereforourfullstudy:Usingbehaviourchangeinterventionsto
decreasetobaccouseinNepal

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