An international survey of training programs for treating tobacco dependence.
OBJECTIVE
The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) requires countries to implement tobacco dependence treatment programs. To provide treatment effectively, a country needs trained individuals to deliver these services. We report on the global status of programs that train individuals to provide tobacco dependence treatment.


METHODS
Cross-sectional web-based survey of tobacco treatment training programs in a stratified convenience sample of countries chosen to vary by WHO geographic region and World Bank income level.


METHODS
Key informants in 48 countries; 70% of 69 countries who were sent surveys responded.


METHODS
Program prevalence, frequency, duration and size; background of trainees; content (adherence to pre-defined core competencies); funding sources; challenges.


RESULTS
We identified 61 current tobacco treatment training programs in 37 (77%) of 48 countries responding to the survey. Three-quarters of them began in 2000 or later, and 40% began after 2003, when the FCTC was adopted. Programs estimated training 14,194 individuals in 2007. Training was offered to a variety of professionals and paraprofessionals, but most often to physicians and nurses. Median program duration was 16 hours, but programs' duration, intensity and size varied widely. Most programs used evidence-based guidelines and reported adherence to core tobacco treatment competencies. Training programs were less frequent in low-income countries and in Africa. Securing funding was the major challenge for most programs; current funding sources were government (58%), non-government organizations (23%), pharmaceutical companies (17%) and, in one case, the tobacco industry.


CONCLUSIONS
Training programs for tobacco treatment providers are diverse and growing. Most upper- and middle-income countries have programs, and most programs appear to be evidence-based. However, funding is a major challenge. In particular, more programs are needed for non-physicians and for low-income countries.
Rigotti
Nancy A
NA
Tobacco Research and Treatment Center and General Medicine Division, Massachusetts General Hospital, Boston, MA 02114, USA. nrigotti@partners.org
Bitton
Asaf
A
Richards
Ann E
AE
Reyen
Michele
M
Wassum
Kenneth
K
Raw
Martin
M
D003430:Cross-Sectional Studies; D004493:Education / Q000458:organization & administration; D006801:Humans; D016730:Program Development / Q000191:economics / Q000592:standards; D016540:Smoking Cessation; D000074606:Smoking Prevention; D019460:Tobacco Industry; D014029:Tobacco Use Disorder / Q000628:therapy*; D014944:World Health Organization