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Introduction: Although tobacco dependence treatment (TDT) is key to tobacco control, there continues to be a shortage of services in the Eastern Mediterranean Region (EMR). Barriers to offering services include the lack of training and education.Aims: To create a network of healthcare providers (HCPs) capable of advancing TDT, King Hussein Cancer Center – the regional host for Global Bridges in the EMR – developed, implemented, and evaluated a regional TDT training programme.Methods: The programme employed a predisposing–enabling–reinforcing framework, and utilised a combination of learning techniques. The evidence-informed curriculum aimed to influence knowledge, confidence, and competence, and the evaluation mechanism was aligned with these aims.Results and discussion: Training produced a 37% and 23% gain in knowledge and TDT-specific competencies, respectively. The majority of participants reported that the workshops enhanced confidence, and 72% reported intentions for positive change. Participants rated the workshops highly, and anticipated value from joining Global Bridges network. Immediate outcomes indicate success in advancing participants’ self-efficacy and readiness to treat. Intentions for positive change may potentially be the first step in modifying practice.Conclusion: Capacity building in TDT could be the first step in meeting the need for trained HCPs through positively influencing knowledge, confidence, competence, and intentions. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to assess the predictive value of smoking history on breast cancer diagnosis in a referral clinic population. We conducted a case–control study using clinical data collected on 8,097 female patients (1,225 breast cancer cases and 6,872 controls) seen in the Mayo Clinic Breast Clinic between August 1, 1993 and November 31, 2003. Breast cancer patients and noncancer patients significantly differed with respect to age at time of the index visit (p < 0.001), number of pregnancies (p = 0.006), number of live births (p = 0.002), vital status at last known follow-up (p < 0.001), current menstruation (p < 0.001), age at menopause (p < 0.001), history of hysterectomy (p < 0.001), use of oral contraception (p = 0.05), duration of oral contraception use (p = 0.001), use of other exogenous hormones (p < 0.001), duration of exogenous hormone use (p = 0.05), breast pain at time of index visit (p = 0.002), smoking status (p < 0.001), and use of five or more alcoholic beverages per week (p = 0.002). After adjustment for these baseline characteristics, having a personal history of smoking was found to be predictive of breast cancer diagnosis (odds ratios [OR] = 1.25, p = 0.004). Other positive predictors for breast cancer diagnosis were: age (OR = 1.02, p < 0.001), history of hysterectomy (OR = 0.66, p < 0.001), prior use of oral contraception for more than 11 years (OR = 2.10, p < 0.001), and prior use of other exogenous hormones/estrogen (OR = 1.81, p < 0.001). In this referral practice having a personal history of smoking is predictive of breast cancer diagnosis. Further studies are needed to further explore this relationship. [ABSTRACT FROM AUTHOR]