title: Building Evidence-Based Tobacco Treatment in the Eastern Mediterranean Region: Lessons Learned by the Syrian Center for Tobacco Studies.
abstract: The tobacco epidemic in Syria is characterized by high rates of cigarettes smoking in men and dramatic reemergence of waterpipe smoking, especially among youths and women. The Syrian Center for Tobacco Studies (SCTS), an NIH-funded pioneer research and capacity building institution, has developed a research infrastructure and conducted three randomized clinical trials to develop and rigorously test culturally-appropriate tobacco treatment programs integrated into primary healthcare (PHC) centers. This review aimed to discuss challenges and lessons learned from the Syrian experience. Addressing these challenges may inform future cessation research activities in Syria and other developing countries. To develop a research infrastructure, the SCTS has established Syria's first IRB and trained physicians/medical students in both tobacco treatment and research methods. Main challenges to conduct the cessation trials were difficulties of coordination between the local and international collaborators; high Smoking Rates among PHC providers; lack of pharmacological agents used in tobacco treatment; and difficulties of conducting research in a politically volatile region. Strategies to overcome these challenges were ensuring an active and regular involvement of all investigator; and advocating for a national smoking-cessation plan that involves training health care providers in smoking cessation treatment and make pharmacological agents used in smoking cessation available.
authors: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; Syrian Center for Tobacco Studies, Aleppo, Syria.
authors: Taghrid
authors: T
authors: Asfar
authors: Syrian Center for Tobacco Studies, Aleppo, Syria; Division of Social and Behavioral Sciences, School of Public Health, University of Memphis, Memphis, TN, USA.
authors: Kenneth D
authors: KD
authors: Ward
authors: Syrian Center for Tobacco Studies, Aleppo, Syria.
authors: Radwan
authors: R
authors: Al-Ali
authors: Syrian Center for Tobacco Studies, Aleppo, Syria; Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
authors: Wasim
authors: W
authors: Maziak
keywords: Eastern Mediterranean Region; Evidence-based tobacco treatment; developing country; lesson learned; randomized clinical trial; waterpipe use