1. Developing and implementing a smoking cessation intervention within the PAL programme in Nepal Health Research and Social Development Forum (HERD), Nepal

2. Background to the Study  Feasibility study  Supported by University of Leeds (UK) COMDIS- HSD programme  Funded by DfID  18 months: July 2012 to Dec 2013

3. Aims and Objectives Aim: To develop and test the feasibility of a behavioural support intervention to promote smoking cessation within primary care in Nepal. Objectives:  To review current evidence on behavioural support interventions for smoking cessation in LMICs.  To develop the intervention using qualitative methods to inform the form, content and delivery mechanism of the intervention.  To use action research to test and evaluate a behavioural support intervention for smoking cessation.  To work with WHO and NTP to scale up the adapted PAL across NTPs PAL districts, primary care in Nepal and with WHO's PAL programme internationally.

4. Methods Phase 3 Implementation and follow upFollow up: Fagerstrom and CO monitors Phase 2 Intervention development workshop Action Research: baseline Fagerstrom and CO monitor Phase 1 Evidence Review Qualitative Interviews with lung health patients and FGDs with PHC staff

5. Phase 1: Qualitative Interviews and Focus Groups  Qualitative interviews with lung health patients  Selected by health workers  Conducted in health centres or place convenient to patients  Aimed for male and female and different lung health conditions Aim to understand community perceptions of smoking, smoking habits and interest/support for quitting.  Focus groups with health workers in the selected PHCCs to understand current practice, knowledge and ideas for the intervention.

6. The Action Research Cycle PLAN ACT OBSERVE REFLECT

7. Selection of Study Sites Selection of Primary Health Care Centres (PHCCs) 1 in Kathmandu and 2 in Rupandehi, Terai (semi-urban and rural) Main criteria for the selection of PHCCs:  At least 2 staff trained in PAL  High case load of lung health patients  An urban/rural mix  Enthusiasm of the PHCC team to participate in the study