1. 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 King Hussein Cancer Center Regional Director, EMR Global Bridges

2. 2 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%

3. 3 THE ENVIRONMENT IN THE EASTERN MEDITERRANEAN REGION

4. 4 A region plagued with tobacco use Percent of males who smoke cigarettes (2010 or latest available) The Tobacco Atlas, 4 th edition

5. 5 Young populations with substantial per capita cigarette consumption Annual Cigarette Consumption (per capita, 2009, total population) The Tobacco Atlas, 4 th edition

6. 6 Health professionals in need of help Smoking prevalence among health professions students (2010 or latest available) The Tobacco Atlas, 4 th edition

7. 7 Cigarettes highly affordable... Cigarette Affordability (relative income price, 2009) The Tobacco Atlas, 4 th edition

8. 8...where treatment is lacking or not covered Quitting Resources Available by Country (2010) The Tobacco Atlas, 4 th edition

9. 9 STRATEGY IN THE EASTERN MEDITERRANEAN

10. 10 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

11. 11 EXECUTION OF STRATEGY

12. 12 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

13. 13 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

14. 14 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

15. 15 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

16. 16 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

17. 17 COMPLETED WORK

18. 18 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

19. 19 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

20. 20 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

21. 21 Reach – geographic Workshops Participants

22. 22 “Tobacco Dependence Treatment” Two –day Training Workshop January 2012 Dubai - UAE Completed Work - EMR

23. 23 “Tobacco Dependence Treatment” Three –day Training Workshop December 2012 Fes - Morocco Completed Work - EMR

24. 24 “Tobacco Dependence Treatment” Three -day Training Workshop October 2012 Abu Dhabi - UAE Completed Work - EMR

25. 25 “NCD Prevention through Health Lifestyles” One-day Training Workshop October 2012 Amman – Jordan Completed Work - EMR

26. 26 “Tobacco Dependence Treatment” Two -day Training Workshop July 2012 Amman - Jordan Completed Work - EMR

27. 27 “Tobacco Dependence Treatment” Three -day Training Workshop June 2012 Tunis - Tunisia Completed Work - EMR

28. 28 “Tobacco Dependence Treatment” Three -day Training Workshop April 2012 Abu Dhabi - UAE Completed Work - EMR

29. 29 “Tobacco Dependence Treatment” Three -day Training Workshop March 2012 Cairo - Egypt Completed Work - EMR

30. 30 “Tobacco Dependence Treatment” Three -day Training Workshop December 2011 Tunis - Tunisia Completed Work - EMR

31. 31 “Tobacco Dependence Treatment Training” Two-day Training Workshop April 2011 Amman-Jordan Completed Work - EMR

32. 32 “Tobacco Dependence Treatment: Global Experience and Regional Perspective” Four-day Regional Conference June 2011 Amman-Jordan Completed Work - EMR

33. 33 NEXT STEPS

34. 34 Fulfilling Article 14  Developing regional guidelines  Expanding reach for patient recruitment (PHC and workplaces)  Availing supporting tools (quitlines, smokefree policies)

35. 35 THANK YOU