Despite the rapidly increasing burden of tobacco-related morbidity and mortality in low- and middle-income countries, tobacco control initiatives – especially cessation – receive little emphasis. This is true despite low-cost methods that have potential for widespread dissemination. The purpose of this paper is to provide a case study example of how lay interventionists may be trained and supported to facilitate tobacco use cessation, based on the successful Tobacco-Free Teachers–Tobacco-Free Society program (TFT–TFS) implemented in Bihar, India. This school-based program included multiple components, with lay interventionists having a crucial role. The lay interventionists included health educators and lead teachers, both of whom were selected based on formative research, underwent extensive training and received continuing support. We emphasized encouraging and supporting teachers to quit tobacco use and engaging both tobacco users and nonusers to create a supportive environment for cessation. We also stressed that neither the health educators nor lead teachers were being trained as counselors or as cessation experts. We focused on the importance of respecting teachers as individuals and identifying locally relevant methods of cessation. Although we cannot isolate the precise contribution of the lay interventionists to the successful TFT–TFS intervention, the abstinence findings in favor of the intervention at follow-up are highly encouraging. Teachers have been neglected as lay interventionists for tobacco cessation despite the fact that they tend to be highly respected and credible. The approach used for TFT–TFS could be disseminable in multiple low- and middle-income country contexts through train-the-trainer programs targeted to teachers.

中文翻译：

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培训非专业干预人员以支持印度教师戒烟

尽管低收入和中等收入国家烟草相关的发病率和死亡率负担迅速增加，但烟草控制举措——尤其是戒烟——很少受到重视。尽管低成本方法具有广泛传播的潜力，但情况确实如此。本文的目的是提供一个案例研究示例，说明如何根据在比哈尔邦成功实施的无烟草教师-无烟草社会计划 (TFT-TFS) 培训和支持非专业干预人员以促进戒烟，印度。这个以学校为基础的计划包括多个组成部分，非专业干预者起着至关重要的作用。非专业干预者包括健康教育者和带头教师，他们都是根据形成性研究挑选出来的，接受了广泛的培训并得到了持续的支持。我们强调鼓励和支持教师戒烟，让烟草使用者和非使用者都参与创造一个支持戒烟的环境。我们还强调，健康教育者和带队教师都没有接受过辅导员或戒烟专家的培训。我们专注于尊重教师作为个人的重要性，并确定当地相关的戒烟方法。尽管我们无法确定非专业干预者对成功的 TFT-TFS 干预的确切贡献，但有利于后续干预的戒断结果非常令人鼓舞。教师作为戒烟的非专业干预者一直被忽视，尽管他们往往受到高度尊重和信任。