1 Global Bridges Work in the Eastern Mediterranean Region Feras I Hawari, MD Chief of Pulmonary and Critical Care Service Director of Cancer Control Office.

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Global Bridges Work in the Eastern Mediterranean

Region

Feras I Hawari, MDChief of Pulmonary and Critical Care Service

Director of Cancer Control Office King Hussein Cancer Center

Regional Director, EMRGlobal Bridges

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Regional Host in EMR

King Hussein Cancer Center (KHCC)- Dedicated to comprehensive cancer care- Disease-specific accreditation by JCAHO- Campus 100% smoke-free

Cancer Control Office at KHCC- Established in 2010- Undertakes evidence-based interventions to lower

cancer incidence, and related morbidity and mortality

Tobacco Dependence Treatment Clinic at KHCC- Established in 2008- Enrolled a total of 890 patients- One-year continuous abstinence rate of 21%

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THE ENVIRONMENT IN THE EASTERN MEDITERRANEAN REGION

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A region plagued with tobacco use

Percent of males who smoke cigarettes (2010 or latest available)The Tobacco Atlas, 4th edition

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Young populations with substantial per capita cigarette

consumption

Annual Cigarette Consumption (per capita, 2009, total population)The Tobacco Atlas, 4th edition

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Health professionals in need of help

Smoking prevalence among health professions students(2010 or latest available)The Tobacco Atlas, 4th edition

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Cigarettes highly affordable ...

Cigarette Affordability (relative income price, 2009)The Tobacco Atlas, 4th edition

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...where treatment is lacking or not covered

Quitting Resources Available by Country (2010)The Tobacco Atlas, 4th edition

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STRATEGY IN THE EASTERN MEDITERRANEAN

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Article 14: Demand reduction measures concerning tobacco

dependence and cessation Short-term strategy: build a network of professionals to treat and advocate

Focus training on TDT

Mid-term strategy: mobilize network to address requirements of Article 14

Focus regional guidelines

integration into PHC

extending reach through workplaces

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EXECUTION OF STRATEGY

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Built the Infrastructure

Scanned status of tobacco control and tobacco dependence treatment in selected countries

Recruited “Regional Consultants”; in-country counterparts

Looking at some training programs world-wide

Defined profile of candidate trainee

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Established Multi-disciplinary Core Team Experience in establishing TDT clinics

Experience in offering TDT services Experience in strategizing, and M&E Experience in design and delivery of training Peer-reviewed publications in field Comprehensive tobacco control experience Qualifications on the team include: medicine,

pharmacy, nursing, engineering, public health, health services management, business administration, health services research

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Designed the Training Program Two- to three-day training workshops

Twelve to 16 hours of training time

Didactic, interactive exercises, case studies

Objectives:• Enhance understanding of tobacco control and

TDT• Build capacity to handle various cases of TDT • Advance TDT in country through preparing

participants to practice and train

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Designed the Training Program (2)

Topics covered:• Tobacco control strategies• Tobacco control in country• Tobacco and disease• Tobacco and addiction• Evidence on treatment• Assessing individual cases• Counseling and motivational interviewing• Pharmacotherapy• Designing a plan• Case studies• Ethical considerations

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Set the Evaluation Mechanism

Of trainee: Pre-workshop test Post-workshop test and case study

Of workshop (qualitative and quantitative): Alignment with expectations,

practicability of content, and relevance to practice

Knowledge and style of trainers

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COMPLETED WORK

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Reach - stats

Trained 500 healthcare professionals and advocates

Conducted 11 events

Engaged 17 countries

Recruited 21 Regional Consultants

Engaged 36 speakers in different events

CME accreditation through Dubai Health Authority and Abu Dhabi Health Authority

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Reach - specialties

• Cardiologists• Oncologists• Pulmonologists• Internists• Registered nurses• Nutritionists• Dentists• Respirologists• Counselors• Psychiatrists• Health educators• Environmental health specialists• Occupational health specialists

• General medicine• Community medicine• Family medicine• Public health specialists• University professors• Physiotherapists• Pharmacists• Occupational health specialists• Tobacco control practitioners• School teachers

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Presenting in Global Forums

• World Conference on Tobacco or Health – Singapore - March 2012

• UICC World Cancer Congress - Montreal - August 2012

• The Second Middle East Asthma and COPD Conference – Kuwait - November 2012

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Reach – geographic

Workshops

Participants

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“Tobacco Dependence Treatment” Two –day Training Workshop January 2012Dubai - UAE

Completed Work - EMR

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“Tobacco Dependence Treatment” Three –day Training Workshop December 2012Fes - Morocco


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“Tobacco Dependence Treatment” Three -day Training Workshop October 2012Abu Dhabi - UAE


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“NCD Prevention through Health Lifestyles” One-day Training Workshop October 2012Amman – Jordan


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“Tobacco Dependence Treatment” Two -day Training Workshop July 2012Amman - Jordan


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“Tobacco Dependence Treatment” Three -day Training Workshop June 2012Tunis - Tunisia


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“Tobacco Dependence Treatment” Three -day Training Workshop April 2012Abu Dhabi - UAE


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“Tobacco Dependence Treatment” Three -day Training Workshop March 2012Cairo - Egypt


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“Tobacco Dependence Treatment” Three -day Training Workshop December 2011 Tunis - Tunisia


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“Tobacco Dependence Treatment Training” Two-day Training Workshop April 2011 Amman-Jordan


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“Tobacco Dependence Treatment: Global Experience and Regional Perspective” Four-day Regional Conference June 2011 Amman-Jordan


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NEXT STEPS

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Fulfilling Article 14

Developing regional guidelines

Expanding reach for patient recruitment (PHC and workplaces)

Availing supporting tools (quitlines, smokefree policies)

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THANK YOU

1 Global Bridges Work in the Eastern Mediterranean Region Feras I Hawari, MD Chief of Pulmonary and Critical Care Service Director of Cancer Control Office.

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