Tobacco Control Network among Women in Parana, Brazil - II

描述（由申请人提供）：在过去几年出版的具有里程碑意义的指导性文件（例如《世界卫生组织烟草控制框架公约》）中，强调了对妇女及其烟草相关问题的理解，以及发展与性别相关的烟草控制工作的必要性，并将其作为优先事项。巴西是世界第二大烟草生产国，95%的烟草产自南部三个州（帕兰、圣卡塔琳娜州和南巴西格兰德州）。虽然从历史上看，发展中国家特别是拉丁美洲妇女的烟草使用率相对于男子较低，但吸烟流行病正在迅速向发展中国家的妇女蔓延，这三个南部州是该国妇女吸烟流行率最高的州。我们在巴西帕兰卡建立了妇女烟草控制网络，目的是建立社区和机构能力，通过社区参与性研究和培训促进妇女中与性别相关的烟草控制工作。该网络的目标是减少巴兰妇女的烟草使用和接触环境烟草烟雾，并培养一支训练有素的研究人员骨干队伍，他们将继续在多个层面处理全面的烟草控制战略。该网络开展了一项流行病学调查，调查了帕兰卡州各地妇女的吸烟流行率和与吸烟有关的因素。根据研究结果，该网络确定了四个优先事项：(1)实施政策改革以减少ETS；(2)了解烟草种植中妇女的健康/社会问题；(3)制定和评估一项全面的、与文化和性别相关的、以学校为基础的预防吸烟计划；(4)通过公共卫生系统改善戒烟计划的获取和实施，特别关注“轻度吸烟者”，因为在我们的研究中，74.8%的女性吸烟者报告每天吸烟10支或更少。该网络目前正在处理前三个优先事项，包括支持立法，这使得帕兰在该国拥有最严格的室内烟草禁令。这一更新的总体目标有三个方面：(1)继续维持和加强网络；(2)开展一项群体随机对照试验，以评估基于理论的、与文化和性别相关的社区卫生工作者对巴西女性“轻度吸烟者”的干预效果，这将增强公共卫生系统提供的戒烟计划；(3)将我们目前的职业发展和研究培训计划扩展到另外两个主要的烟草种植州，以培养一支训练有素的研究人员骨干队伍，他们将继续在各级制定和实施与性别相关的综合烟草控制战略。

DESCRIPTION (provided by applicant): An understanding of women and their tobacco-related issues, as well as the need for the development of gender-relevant tobacco control efforts, have been highlighted as priorities in landmark guiding documents published in the past few years (e.g., WHO Framework Convention on Tobacco Control-WHO FCTC). Brazil is the second largest producer of tobacco in the world, and 95% of the tobacco is produced in the three Southern states (Paran¿, Santa Catarina, and Rio Grande do Sul). Although, historically, tobacco use among women in developing countries, particularly Latin America, has been relatively low as compared to men, the smoking epidemic is rapidly spreading to women in developing countries, and these three Southern states have the highest prevalence of women smokers in the country. We have established a Network for Tobacco Control among Women in Paran¿, Brazil with the purpose of establishing community and institutional capacity to promote gender-relevant tobacco control efforts among women through Community-Based Participatory Research (CBPR) and training. The goals of the network are to reduce tobacco use and exposure to environmental tobacco smoke (ETS) among women in Paran¿, and to develop a cadre of well-trained researchers who will continue to address comprehensive tobacco control strategies at multiple levels. The network conducted an epidemiological survey on the prevalence and factors associated with tobacco use among women across the State of Paran¿. Based on the results, the network identified four priorities: (1) to implement policy changes to decrease ETS; (2) to understand the health/social issues of women in tobacco farming; (3) to develop and evaluate a comprehensive, culturally- and gender relevant, school-based smoking prevention program; and (4) to improve access and delivery of smoking cessation programs through the public health system with a particular focus on "light smokers" as 74.8% of women smokers in our study reported smoking 10 or less cigarettes/day. The network is currently addressing the first three priorities, including support for legislation, which resulted in Paran¿ having the strongest indoor tobacco ban in the country. The overall goal of this renewal is three-fold: (1) to continue to sustain and strengthen the network; (2) to conduct a group randomized controlled trial to assess the efficacy of a theory-based, culturally- and gender- relevant Community Health Worker intervention for Brazilian women "light smokers" that will augment the smoking cessation programs offered through the public health system; and (3) to expand our current Career Development and Research Training Program to the other two major tobacco growing states in order to develop a cadre of well-trained researchers who will continue to develop and implement gender-relevant comprehensive tobacco control strategies at all levels.