Establishment of the Syrian Center for Cancer

描述(由申请人提供)：这项研究将主要在叙利亚阿勒颇的叙利亚抗癌协会(SCTS)与Wasim Maziek医学博士合作完成，作为NIH补助金*R01TW005962的延伸。药物依赖涉及一种精神活性物质的反复自我给药，尽管已知的健康风险、高昂的经济成本和多次戒烟尝试。烟草依赖是一个特别致命的例子，目前每年导致全球490万人死亡，预计这一数字在未来20年将翻一番(世界卫生组织[世卫组织]，1998年)。在这些死亡中，70%预计将发生在发展中国家(世卫组织，1998年)。尽管发展中国家首当其冲，但大多数烟草研究和治疗工作并没有考虑发展中国家常见的烟草使用方法。在包括东地中海地区(EMR)在内的许多发展中国家，使用水管是很常见的，涉及吸入通过水的烟草烟雾。数以百万计的人每天使用水管，越来越多的证据表明，使用水管是一种产生依赖的现象。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。和吸烟一样，水烟斗的使用也与癌症、心血管疾病和肺功能受损有关。然而，与吸烟不同的是，没有干预措施帮助水烟使用者戒烟，可能是因为人们对水烟吸烟者的依赖程度和特征知之甚少。这项建议利用SCTS的研究优势来加深我们对水管依赖的理解，并制定水管依赖的测量方法。我们建议1)通过对现任和前任水管使用者进行关键线人访谈和焦点小组，进一步形成我们对水管依赖特征的形成工作；2)根据当前的药物依赖理论和形成工作的结果，开发水管依赖的模型和测量；以及3)在600名水管使用者的样本中测试该测量，以确定其心理测量学特性，包括预测有效性。与公共卫生的相关性：鉴于这种致命的和可能使人上瘾的烟草使用形式在世界范围内日益流行，了解依赖潜力和治疗水烟斗使用者是全球卫生优先事项。

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.