Establishment of the Syrian Center for Cancer

描述（由申请人提供）：本研究将主要在叙利亚阿勒颇的叙利亚抗癌协会（SCTS）进行，与Wasim Maziek， MD， PhD合作，作为NIH拨款* R01TW005962的延伸。药物依赖是指不顾已知的健康风险、高昂的财务成本和多次戒烟尝试，反复自我服用精神活性物质。烟草依赖是一个特别致命的例子，目前每年在全世界造成490万人死亡，预计这一数字在今后20年内将翻一番（世界卫生组织[卫生组织]，1998年）。在这些死亡中，预计70%发生在发展中国家（世卫组织，1998年）。尽管发展中国家在这一流行病中首当其冲，但大多数烟草研究和治疗工作并未考虑发展中国家常见的烟草使用方法。在许多发展中国家，包括东地中海地区的发展中国家，水管的使用很普遍，并且涉及吸入通过水传播的烟草烟雾。每天有数百万人使用水管，越来越多的证据表明，水管的使用是一种依赖现象。了解水管依赖的程度和特征可能对减少其对健康的负面影响至关重要。与吸烟一样，使用水烟也与癌症、心血管疾病和肺功能受损有关。然而，与吸烟不同的是，没有干预措施可以帮助水烟使用者戒烟，也许是因为人们对水烟使用者依赖的程度和特征知之甚少。本提案利用SCTS的研究优势，进一步加深我们对水管依赖的理解，并制定水管依赖措施。我们建议：(1)通过对主要信息提供者进行访谈和对现有和以前的水管使用者进行焦点小组讨论，进一步开展有关水管依赖特征的形成性工作；2)在现有药物依赖理论和形成性工作成果的基础上，建立水烟依赖模型和测量方法；3)在600名水管使用者样本中测试该测量，以确定其心理测量特性，包括预测效度。与公共卫生的相关性：鉴于这种致命和可能上瘾的烟草使用形式在世界范围内日益普遍，了解潜在的依赖和治疗水烟使用者是全球卫生的优先事项。

DESCRIPTION (provided by applicant): This research will be done primarily in Aleppo, Syria at the Syrian Society Against Cancer (SCTS) in collaboration with Wasim Maziek, MD, PhD, as an extension of NIH grant* R01TW005962. Drug dependence involves repeated self-administration of a psychoactive substance, despite known health risks, high financial costs, and multiple quit attempts. Tobacco dependence is a particularly lethal example, currently causing 4.9 million deaths worldwide each year, with this number expected to double in the next 20 years (World Health Organization [WHO], 1998). Of these deaths, 70% are expected to occur in developing countries (WHO, 1998). Despite the fact that developing countries bear the brunt of the epidemic, most tobacco research and treatment efforts do not consider tobacco use methods that are common in developing countries. Waterpipe use is common in many developing countries, including those in the Eastern Mediterranean region (EMR), and involves inhaling tobacco smoke that has passed through water. Millions use waterpipes daily, and growing evidence indicates that waterpipe use is a dependence-producing phenomenon. Understanding the extent and features of waterpipe dependence may be critical to reducing its negative health effects. Like cigarette smoking, waterpipe use is associated with cancer, cardiovascular disease, and impaired pulmonary function. Unlike cigarette smoking however, there are no interventions to help waterpipe users quit, perhaps because so little is known about the extent and features of dependence in waterpipe smokers. This proposal uses the SCTS' research strengths to further our understanding of waterpipe dependence and develop a waterpipe dependence measure. We propose to 1) further our formative work on waterpipe dependence features by conducting key informant interviews and focus groups with current and former waterpipe users; 2) develop a model and measure of waterpipe dependence, based on current theory in drug dependence and results of formative work; and 3) Test the measure in a sample of 600 waterpipe users to determine its psychometric properties, including predictive validity. Relevance to public health: Given the increasing worldwide prevalence of this deadly and potentially addictive form of tobacco use, understanding dependence potential and treating waterpipe users is a global health priority.