Health Warnings and Counseling at Primary Health Care Centers for Smoking Cessation and NCD Prevention: A Randomized Controlled Trial in Bangladesh and Pakistan

What this Trial Is About

Tobacco use remains high across South Asia, contributing significantly to diseases like cardiovascular disease, hypertension, diabetes, and stroke. Researchers are evaluating the effectiveness and cost-effectiveness of combining graphic health warnings (GHWs) with personalized counseling led by community pharmacists at primary healthcare pharmacies in Bangladesh and Pakistan. This cluster randomized controlled trial aims to find better ways to help smokers quit and reduce non-communicable disease risks in these regions. Participants will be randomly assigned to one of three groups: one group receives only GHWs with printed booklets and monthly SMS reminders; another group receives GHWs plus pharmacist-led counseling sessions at baseline and six months, along with monthly SMS reminders; the third group receives standard pharmacy services without additional materials or counseling. Counseling is delivered twice yearly, both in person and supported by educational leaflets. During the study, participants will be assessed at baseline, six months, and twelve months for smoking status, cigarette consumption, quit attempts, awareness of smoking harms, physical activity, diet, quality of life, and management of hypertension and diabetes. Researchers will use questionnaires, self-reports, and biomarker assessments to measure outcomes. The main outcome is self-reported 7-day smoking abstinence at 12 months, with safety and feasibility also monitored. The study spans over a year with ongoing follow-ups and data collection.

Health Warnings and Counseling for Smoking Cessation