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Rima Nakkash, professor in George Mason University's College of Public Health, and University of Florida colleague Ramzi Salloum lead a five-year grant from the National Cancer Institute to compare the effectiveness of evidence-based tobacco treatment interventions in Lebanon.
Lebanon is ranked third in the world for highest cigarette consumption per person, where 35% of adults smoke cigarettes and 39% smoke water pipes. In comparison, in the United States, 12.5% of people smoke cigarettes. Although Lebanon has the highest incidence of lung cancer for females and second highest for males in the Eastern Mediterranean region, public resources to support smoking cessation are scarce.
With a National Institutes of Health National Cancer Institute grant, Rima Nakkash, professor in Mason's College of Public Health, and University of Florida colleague Ramzi Salloum will lead a study to compare the effectiveness of evidence-based tobacco treatment interventions in Lebanon.
“There are many barriers to implementing smoking cessation programs in Lebanon, such as lack of public resources to support smoking cessation and no nicotine replacement therapy in the market. We’re seeking to understand what approaches – or combination of approaches – will help overcome those barriers. The project addresses a critical gap in the research and could serve as a model for similar efforts globally,” said Nakkash.
The team will compare three approaches of tobacco cessation in Lebanon’s primary health care centers, which serve more than half of the population. The interventions will build on evidence around the success of behavioral counseling and pharmacotherapy (medication) to assist in stopping smoking. The first approach involves following standard care, including asking the patient about tobacco use, advising the patient to stop smoking, and providing the patient with brief counseling. The second approach involves phone-based counseling, and the third approach combines phone-based counseling with nicotine replacement therapy.
“Our long-term goal is to reduce tobacco use by developing sustainable models for implementing evidence-based tobacco dependence treatment in low-resource settings, in partnership with existing health systems,” said Salloum.
Nakkash is building on decades of experience in tobacco control intervention research. She is a leader in implementing and evaluating tobacco control policies in Lebanon and the Eastern Mediterranean region.
The National Institutes of Health National Cancer Institute R01 grant was awarded to the University of Florida and Mason is subcontracted for the project, “Phone Enabled Implementation of Cessation Support (PHOENICS).” Nakkash is the principal investigator at Mason. The research is conducted in collaboration with the Primary Health Care Centers of the Ministry of Public Health as a main stakeholder.
Other research team members include Maya Romani and Fadi El Jardali from the American University of Beirut; and Donna Shelley from New York University; and Ji-Hun Lee and Ryan Theis from the University of Florida.