Epidemiology & Intervention Research for Tobacco Control
Condition: Lung Diseases
MeSH terms: Lung Diseases
Study type: Observational

Summary: 
      To characterize the development of tobacco control capacity with staff from the Chinese
      Center's for Disease control (CDCs) at the provincial level and to have them develop and
      implement population-level interventions to build awareness and knowledge concerning the
      harms of smoking that could help lead to policy action being taken to protect the population
      from the harms caused by smoking. Compare capacity, policy and, second-hand smoke exposure
      and smoking rates in selected provinces to national levels.
    

Detailed description: 
      China is a particularly critical country for global tobacco control. It has the world's
      largest number of smokers, approximately 350 million, and the immense market afforded by the
      60 percent of men who smoke and the 95 percent of women who do not smoke represents a prize
      target for the multinational tobacco companies. China has ratified the Framework Convention
      for Tobacco Control (FCTC) and now needs to implement its provisions across a large and
      diverse population. In this application, we propose a program of evidence-based community
      interventions to be implemented at the province and local levels with the overall objective
      of developing an approach for implementation nationally.

      This application builds on a long-standing partnership between the Chinese Center for Disease
      Control and Prevention (China CDC), the Peking Union Medical College (PUMC) and the Johns
      Hopkins Bloomberg School of Public Health. That partnership began in 1995 with an agreement
      to collaborate on the conduct of China's 1996 national smoking survey. Our principal
      collaborator over those years, Dr. Gong-Huan Yang, is now Deputy Director of the China CDC
      and responsible for tobacco control at the national level. In the four years of funding to
      date from the Fogarty International Center (FIC), we have carried out a project in selected
      communities in three provinces, including urban and rural areas that provide a foundation for
      the intervention approach in this proposal. Specifically, we have carried out quantitative
      and qualitative studies to assess barriers to tobacco control and readiness for
      interventions, measured levels of airborne nicotine in key public environments, and developed
      capacity-building approaches. Our original FIC supported study involved three countries,
      China, Mexico and Brazil. However, this application will focus solely on China, as the latter
      two countries developed the necessary infrastructure and capacity to conduct research,
      publish their research findings, and seek further grants and government funding to sustain
      progress.

      This application proposes a tobacco control study that will involve 7 provinces in a CDC-led
      initiative to develop a systematic mix of approaches. The plan uses strategies based on
      experiences from our work in China and from the American Stop Smoking Intervention Study for
      Cancer Prevention (ASSIST) and anticipates barriers that have been identified in the data
      collected to date. In the intervention provinces, the China CDC will team with the
      provincial-level CDCs to assess capacity for tobacco control and the current status of
      tobacco control, using an adapted version of the Strength of Tobacco Control (SOTC) index
      developed for evaluating ASSIST. This systematic characterization will highlight capacity
      needs. An extensive capacity development program, based in distance-based methods, will be
      used. We have the overall objective of preparing the China CDC to implement a proven approach
      to tobacco control at the national level. A household survey will be conducted and compared
      to the national survey results. Second-hand smoking will be assessed in selected locations in
      the 7 provinces.
    

Observational model: Ecologic or Community
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Household representatives in 7 selected provinces will complete a survey.
      
Biospecimen description: 
      No bio-specimens collected. Sampled nicotine from buildings only.