National framework on TB-Tobacco collaborative activities: most cost-effective way to manage TB-Tobacco comorbidity and extend tobacco cessation servcies
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International Union Against Tuberculosis and Lung Disease, Tobacco Control, India
Ministry of Health and Family Welfare, Government of India, Directorate General of Health Services, India
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A829
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Background and challenges to implementation:
India, globally, has two disreputable distinctions of having the highest TB burden in the world with 2.8M incidence / year (Global Tuberculosis Report 2016) and also housing 2nd largest tobacco consumer with 267 million tobacco users.
Several studies have documented that tobacco consumption may contribute to TB transmission by transforming a dormant infection into active and more infectious disease, can complicate the success of TB treatment, and can increase TB mortality rates.
India is implementing two national health programmes to control TB and Tobacco i.e. Revise National Tuberculosis Control Programme (RNTCP) and National Tobacco Control Programme (NTCP). It is important to integrate these two to reduce comorbidity by collaborative activities.

Intervention or response:
In 2010, RNTCP and NTCP with in collaboration with The Union piloted an intervention of introducing brief advice on tobacco cessation during treatment of TB patients in Vadodara district of Gujarat. The results of were encouraging. Subsequently a working group was formed with representatives of RNTCP, NTCP WHO-India and The Union to develop collaborative framework for TB and other co-morbidity and implementing the same to cover the entire country.

Results and lessons learnt:
In the leadership of the Ministry of Health & Family Welfare, the national framework on TB-Tobacco collaborative activities was developed and released in a national level event. This is to be followed by series of training of work force involved in both the programmes.

Conclusions and key recommendations:
RNTCP will be benefited by this collaboration to manage the comorbidity due to tobacco use among TB patients. This also leverages the robust programme structure of RNTCP to extend brief advice on tobacco quitting without any further investment.

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