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Addressing smokeless tobacco and building research capacity in South Asia

ASTRA is a world-class, international and interdisciplinary group, aiming to reduce the substantial burden of disease caused by smokeless tobacco. Smokeless tobacco is responsible for thousands of deaths per year, but has so far been neglected in policy and research. ASTRA’s international teams will carry out policy research and develop interventions to address the problems caused by smokeless tobacco use in South Asia. Our focus is on Bangladesh, India and Pakistan, where 80% of the world’s 300 million smokeless tobacco users live, and where the most harmful types of smokeless tobacco are favoured. ASTRA is a three-year programme, with a budget of £2M. Dr Subhash Pokhrel and Ms Kathryn Coyle from Health Economics Theme are leading Economics study within ASTRA with an aim to quantify the healthcare costs of smokeless tobacco use in Bangladesh, India and Pakistan.

Aims of ASTRA:

  • To gather evidence about how the policies recommended by the WHO-FCTC are being developed and implemented for smokeless tobacco in LMICs. This part of the programme will focus on young people, since 90% of ST users start their habit during adolescence.
  • To develop and evaluate interventions, such as behavioural support or medicines, to help adult ST users to quit.
  • To build capacity, by training research teams at LMIC institutions to conduct high quality applied health research in Bangladesh, Pakistan and India.
  • To use this capacity to support wider tobacco control efforts in the South Asia region.

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Meet the Principal Investigator(s) for the project

Professor Subhash Pokhrel - Subhash is a professor of health economics and the Head of Department of Health Sciences and the Lead of the Health Economics Research Group (HERG). Subhash's research has contributed to several public health policies. The suite of NICE Public Health ROI Tools – which provided the basis for many public health investment decisions in England - was informed by the work on tobacco control led by Subhash. The ROI tools are practical, customisable models to help make real-world decisions in context of local government decision-making. Economic arguments are needed to make the business case for public health investments. Subhash led the roll out of ROI work to several European nations through a €2 million multi-centre European Commission funded study, EQUIPT. He has been the coordinator of a large scale inter-disciplinary collaboration of national and international expertise. Subhash is the lead author of a book, ROI in Public Health Policy: Supporting Decision Making (Palgrave Macmillan). Subhash’s work in public health research has been as diverse as the discipline itself – from developing a household decision making pathway for child health care in low- and middle income countries (LMICs) to quantifying the economic impact of breastfeeding promotion in industrialised countries; from evaluating health insurance for its population health impact in LMICs to finding out what interventions improve physical activity globally. Subhash is intrigued by the following question: In LMICs and industrialised countries, what works to improve population health outcomes and at what cost? Google Profile Orcid Profile ResearchGate BURA Profile https://www.brunel.ac.uk/about/chmls/health-sciences

Related Research Group(s)

Health Economics (HERG)

Health Economics (HERG) - Our strategic focus is on economic evaluation and systematic reviews of a broad range of clinical and health service technologies by providing high-quality, applied, policy-relevant research, as well as developing and refining methods to increase the rigour and relevance of such studies.

Partnering with confidence

Organisations interested in our research can partner with us with confidence backed by an external and independent benchmark: The Knowledge Exchange Framework. Read more.

Project last modified 20/10/2021