Tobacco control in developing countries will soon receive a US$ 17 million boost from a new programme co-sponsored by the US National Institutes for Health (NIH) and the World Health Organization (WHO).
The International Tobacco Health Research and Capacity Building Programme will, over the next five years, support research on tobacco consumption and related health risks in developing countries and resolve some unanswered questions about how tobacco impacts low and middle-income countries in particular. Besides providing a better understanding of the tobacco burden, the programme will build up the institutional and personnel capacity of developing countries in tackling the tobacco epidemic.
With few exceptions, most tobacco control research to date has concentrated on developed countries. There remain large gaps in knowledge about tobacco consumption, patterns of use, the health impact of traditionally used tobacco products, the efficacy of cessation methods, and other aspects of tobacco use in low and middle-income countries.
What is known for certain is that: tobacco consumption is rising in most developing countries, even dramatically in some populations and age groups; tobacco promotion and advertising is on the rise; and tobacco-related deaths are multiplying rapidly. Around half the 4 million tobacco-related deaths today occur in developing countries. It is estimated that 70% of the tobacco-related deaths will occur in low and middle-income countries starting in 2020—this is more than the deaths caused by HIV/AIDS, malaria, tuberculosis, maternal mortality and childhood diseases combined.
"Developing countries need to act now if they are to save lives. The most effective policies are those backed by the right research and data," said Dr Derek Yach, Executive Director of Noncommunicable Diseases and Mental Health, WHO. "Applied research in Brazil, South Africa and Thailand has led to effective policies. Through this new US-WHO partnership, more countries can enhance their research capacity and strengthen their ability to effectively control tobacco use," he added.
The programme comes at a critical stage in the international tobacco control movement as 191 countries are in the midst of negotiating a Framework Convention on Tobacco Control (FCTC). New evidence on tobacco use and trends in developing countries would assist negotiators as they are working to achieve a strong and effective convention.
Among the many issues that have been identified as potential topics for research is the interaction of smoking and shifting dietary patterns on the development of heart disease. Another is the implication of environmental tobacco smoke as a cause of lung cancer and respiratory disease in both adults and children. In addition, we need to know whether research and interventions on tobacco use by nurses in developing countries could help reduce the tobacco burden in the same way as they have in developed countries. Recent research on the association of smoking with psychiatric disorders among adolescents and young adults needs to be explored in a developing country context. Culturally specific information on gender and age differences in tobacco use and cessation is urgently required in order to design effective policy measures.
"More research is needed on how to either maintain the relatively low smoking rate of women in developing countries or reverse the rising trend of female smoking we see in some countries," said Dr Vera Da Costa e Silva, Project Manager of WHO's Tobacco Free Initiative. She added that "Many women in the developing world use chewing tobacco or other types of smokeless tobacco and we need to find out precisely how their health is affected and what can be done to protect them."
The programme specifies that the major part of the research must be conducted in low or middle-income nations, and that greater than 50% of the grant money must be used in low or middle-income nations for either research or capacity strengthening of institutions in those nations.
"Tobacco consumption is an urgent global health concern," said Dr Gerald Keusch, head of Fogarty International Center on behalf of the six NIH partners. "The global community needs evidence-based information, based on solid research, to effect strategies to prevent and reduce tobacco use," he added.
The deadline for applications is 26 October 2001 and the deadline for receipt of Letters of Intent to apply is 4 September 2001. The Request for Applications is available on line at http://grants.nih.gov/grants/guide/rfa-files/RFA-TW-02-005.html. Application forms are available from the Division of Extramural Outreach and Information Resources, National Institutes of Health, 6701 Rockledge Drive, MSC 7910, Bethesda, MD 20892-7910, USA, telephone (+1 301) 435 0714, e-mail: GrantsInfo@nih.gov. Applications are also available on the World Wide Web at http://grants.nih.gov/grants/forms.htm.