Research led by Prof. Kamran Siddiqi and colleagues on behavioural support for smoking cessation among people with tuberculosis in Pakistan features in the World Health Organization ‘Framework for collaborative action on TB and comorbidities’.
Tobacco consumption and tuberculosis (TB) are two ‘colliding epidemics’ in many low- and middle- income countries of the world. The two epidemics tend to interact and amplify each other’s negative impacts on the health of the population. Patients with TB who stop smoking may have better outcomes than those who don’t. The research team developed a bespoke smoking cessation intervention for people with TB, in a collaborative partnership between the national TB programme in Pakistan. The intervention consists of brief (8 minutes) behavioural support sessions that provide messages on TB, healthy behaviour and advice on how to quit tobacco smoking, delivered by the regular TB programme staff. Evaluation of the intervention in practice showed improved tobacco quit rates and in collaboration with the provincial TB programme, the intervention was scaled up in 59 out of 121 health facilities in the Khyber Pakhtunkhwa Province, representing urban, rural, private and public centres.
The team were able to work closely with national TB programmes to identify strategies to support the scale up of the intervention. Adding patients’ tobacco status to reporting forms and including tobacco cessation within routine training for TB health workers. Embedding the research within TB programmes was a key implementation strategy, which worked well in Pakistan where members of the provincial and federal government were involved as researchers within the team. The project team engaged with the World Health Organization (WHO) at regional and global levels too and brought together WHO TB staff and WHO tobacco control staff.
With so many important lessons learnt, the project is now a case study in the WHO Framework for collaborative action on TB and comorbidities. The wider project and it’s impact in Pakistan, Bangladesh, and Nepal have also been highlighted in a recent case study by the Global Alliance for Chronic Diseases (GACD) on the implementation research approach taken by the TB & Tobacco team.
It is great to see the ongoing global impact of this research. The collaborative approach taken by the team will help guide the Centre’s ongoing work.
Find out more about the TB and Tobacco research project including flipbook, leaflet, posters, health worker guide and training slides and videos at tbandtobacco.org (materials available in Urdu and English).
More about the WHO Framework for collaborative action on tuberculosis and comorbidities
The Framework for collaborative action on TB and comorbidities was published in October 2022. The overarching aim is to support countries in the evidence-informed introduction and scale-up of holistic people-centred services for TB, comorbidities and health-related risk factors, with the goal of comprehensively addressing TB and other co-existing health conditions.
The Framework is for people working in ministries of health, policymakers, international technical and funding organizations, researchers, nongovernmental organizations, as well as primary care workers, specialist health practitioners, and community health workers who support the response to TB and comorbidities in both the public and private sectors. It should be used in conjunction with relevant WHO guidelines.
Download the WHO Framework
Addressing comorbidities and risk factors for TB is a crucial component of the End TB Strategy, which focuses on integrated patient-centred care and prevention, including action on TB and comorbidities. The World Health Organization (WHO) developed the End TB Strategy to ultimately eliminate tuberculosis (TB) from the world. The strategy was endorsed in 2014 by the Sixty-seventh World Health Assembly and aims to “end the global TB epidemic” by 2035.
