title: An international survey of training programs for treating tobacco dependence.
abstract: 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.
authors.affiliation: Tobacco Research and Treatment Center and General Medicine Division, Massachusetts General Hospital, Boston, MA 02114, USA. nrigotti@partners.org
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Rigotti
authors.forename: Asaf
authors.initials: A
authors.lastname: Bitton
authors.forename: Ann E
authors.initials: AE
authors.lastname: Richards
authors.forename: Michele
authors.initials: M
authors.lastname: Reyen
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wassum
authors.forename: Martin
authors.initials: M
authors.lastname: Raw
mesh_terms: 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