Mark Nichter
A team of University of Arizona researchers has been awarded a five-year, $1.5 million grant from the National Institutes of Health, through the Fogarty International Center, to study tobacco cessation in India and Indonesia.
The group includes Regents' Professor of anthropology Mark Nichter, as well as Mimi Nichter, UA associate professor of anthropology, and Myra Muramoto, UA associate professor of family and community medicine.
Tobacco cessation is a thorny health issue that has yet to be addressed in many of the world’s poorer countries. India and Indonesia are two culturally diverse nations where tobacco use, especially smoking, is widespread.
The scale of the problem there and worldwide is profound. About one in three adults, slightly more than 1 billion people, is a smoker. The vast majority of those live in low- and middle-income countries.
Mark Nichter said estimates are that 5 million people each year die prematurely from smoking, a number that will double over the next two decades. More than two thirds of fatalities will come from poorer countries, the majority from India, Indonesia and China.
Besides the sheer force of numbers, health officials are up against other problems as well. Stop-smoking programs have worked successfully in the United States and other Western countries. But in order to be effective elsewhere, health officials need to adopt programs that fit other cultures. That requires research to find adaptations that work in other local contexts.
Nichter said the framework for new programs will come from local medical communities, the forefront of any tobacco cessation efforts. Doctors and other health care providers themselves need to quit smoking, and then begin to routinely ask patients about tobacco use and advise them to quit.
At present, he said, there is little physician involvement on tobacco use in India and Indonesia.
As part of the UA effort, medical schools will be mobilized to train researchers. They also will become centers for pilot studies and create research networks. Based on previous research, Nichter said marshaling a cohort of project researchers in these countries involves a four-step process:
Nichter's current project is built on four years of experience in India and Indonesia through Project Quit Tobacco International that also was funded by a Fogarty initiative. Nichter said lessons learned from that period will help provide the infrastructure for training the next generation of tobacco researchers.
Mark Nichter
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