# Adapting and evaluating a brief advice tobacco intervention in high-reach, low-resource settings in India

> **NIH NIH R01** · DANA-FARBER CANCER INST · 2022 · $622,157

## Abstract

Project Summary: Background: India has 267 million users of smoked and smokeless tobacco, making
cessation efforts critical for addressing tobacco-related cancers and diseases. An important opportunity comes
from brief advice interventions to promote tobacco cessation. These interventions can be delivered in a few
minutes by practitioners and typically include screening for tobacco use, brief counseling, and referral to
services. However, these programs do not meet the needs of the Indian context at this time as they: a) typically
come from high-resource, Western settings, b) emphasize the use of pharmacotherapy, and c) require highly
credentialed staff. We focus here on task-shifting, or using less credentialed workers who are more readily
available than highly credentialed professionals. We will support them through training and technology-based
ongoing supports (using an “app” and a social media channel).
Goal: We will adapt and evaluate the impact of a brief advice intervention for tobacco cessation to be delivered
in dental clinics, tuberculosis clinics, and non-governmental primary health centers. This proposal leverages
investigators' expertise with implementation science and behavioral interventions focused on cancer
prevention and control; the Mumbai-based team's expertise in training practitioners to use brief advice
programs; and the technology partner's expertise in developing apps to support health workers implement
programs.
Methods: This hybrid effectiveness-implementation study will test the impact of an adapted brief advice
intervention on tobacco cessation outcomes and will also collect pilot data regarding implementation factors.
Accordingly, the study draws on a tobacco cessation framework (5 A's) and an implementation science
framework (the Exploration, Preparation, Implementation, and Sustainment framework). The study is organized
around three aims. Aim 1 will include formative research to support adaptation of existing brief advice
interventions. Aim 2 supports a randomized controlled trial to assess effectiveness of the adapted intervention
and gather pilot implementation data. Aim 3 addresses the opportunity to engage trained practitioners in an
ongoing manner through technology-based supports, with an emphasis on linking such engagement to
program delivery.
Innovations and impact: This study is innovative in that it focuses on scaleability at every step – from task
shifting to selecting practitioners outside the primary healthcare system, to using technology to support
practitioners. These features allow for a simple, scaleable brief advice intervention that can be used widely in
low-resource settings in Mumbai as well as other low- and middle-income countries, which is key for impact.
Findings from the study will support scalable tobacco cessation in India and will build the literature on adapting
research evidence from high-income countries to lower- and middle-income countries.

## Key facts

- **NIH application ID:** 10412969
- **Project number:** 5R01CA230355-03
- **Recipient organization:** DANA-FARBER CANCER INST
- **Principal Investigator:** Shoba Ramanadhan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $622,157
- **Award type:** 5
- **Project period:** 2020-06-01 → 2025-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10412969

## Citation

> US National Institutes of Health, RePORTER application 10412969, Adapting and evaluating a brief advice tobacco intervention in high-reach, low-resource settings in India (5R01CA230355-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10412969. Licensed CC0.

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