TB and Tobacco · Project

Proven Smoking Cessation Program Built Into TB Treatment for High-Burden Countries

healthTestedTRL 6Thin data (2/5)

york.ac.uk

When someone is being treated for tuberculosis, they're already in regular contact with health workers and highly motivated to get better — it's a perfect moment to help them quit smoking too. This project built a practical quit-smoking program that rides on top of existing TB clinics in Bangladesh, Nepal, and Pakistan, testing whether a cheap pill called cytisine plus counseling actually works better than counseling alone. They ran a proper clinical trial across 3 countries with real patients in real clinics, then figured out what it would cost to roll this out nationally. The goal was a ready-to-use package that governments and health organizations can just plug into TB programs they already run.

By the numbers

High-burden countries with validated intervention (Bangladesh, Nepal, Pakistan)

Research and implementation partners in consortium

Countries represented in the research consortium

Total project deliverables produced

Work packages covering development through scale-up

The business problem

What needed solving

Tuberculosis and tobacco use overlap heavily in South Asia, where millions of TB patients continue smoking during treatment — worsening outcomes and driving up healthcare costs. Existing quit-smoking programs require specialist infrastructure that these countries lack, and no one has proven a cheap, scalable way to add cessation support inside TB clinics. Health systems, insurers, and pharma companies all lose when patients stay on tobacco through TB treatment.

The solution

What was built

The project produced locally appropriate intervention materials for Bangladesh, Nepal, and Pakistan (confirmed demo deliverable), clinical trial results comparing cytisine plus behavioural support against behavioural support alone, cost-effectiveness data, and a scale-up feasibility assessment across 14 total deliverables.

Audience

Who needs this

Cytisine and smoking cessation drug manufacturers seeking clinical evidence for South Asian marketsDigital health companies building behavioral intervention platforms for low-resource settingsGlobal health consultancies advising on TB control program designHealth ministries and public health agencies in high TB-burden countriesHealth insurers and managed care organizations covering TB treatment populations

Business applications

Who can put this to work

Pharmaceuticals

mid-size

Target: Manufacturers of smoking cessation drugs (especially cytisine producers)

If you are a pharma company producing cytisine or similar cessation medications and looking to expand into South Asian markets — this project generated clinical trial evidence from 3 high-burden countries proving cytisine works in TB patient populations. The RCT data and cost-effectiveness analysis give you the regulatory and health-economic evidence needed to pursue market authorization and formulary inclusion in Bangladesh, Nepal, and Pakistan.

Digital Health

SME

Target: mHealth and telemedicine platform developers

If you are a health tech company building behavioral health apps or remote patient support platforms — this project developed locally adapted intervention materials and behavioral support protocols tested across 3 countries. The process evaluation data from 6 work packages reveals exactly what works and what fails in low-resource clinical settings, giving you a validated blueprint for digitizing the cessation support component.

Public Health Consulting

any

Target: Global health consultancies and NGOs implementing TB programs

If you are a consulting firm advising governments or donors on TB control programs — this project delivered a complete scale-up and sustainability assessment with cost analysis for integrating cessation into existing TB infrastructure. The 10-partner consortium across 6 countries produced intervention materials ready for adaptation, plus evidence on obstacles and opportunities for national rollout.

Frequently asked

Quick answers

What would it cost to implement this cessation program?

The project conducted a full cost-effectiveness analysis (WP3) comparing cytisine with behavioural support versus behavioural support alone. Based on available project data, the scale-up assessment (WP6) identified likely costs for national rollout, but specific figures would need to be obtained from the research team.

Has this been tested at real-world scale?

Yes — the project ran a randomized controlled trial in actual TB clinics across Bangladesh, Nepal, and Pakistan. This was not a lab study but a 'real world' test with real patients in existing health infrastructure across 3 countries with high dual burden of TB and tobacco use.

What about intellectual property and licensing?

This was a publicly funded Research and Innovation Action (RIA). The intervention materials were developed as locally appropriate resources for Bangladesh, Nepal, and Pakistan. Based on available project data, the outputs are likely accessible for public health use, though specific licensing terms should be confirmed with the University of York.

Does this work meet regulatory requirements?

The project followed rigorous clinical trial methodology (RCT design) and included process evaluation and context evaluation work packages. Cytisine is already an approved medication in several countries. The evidence generated supports regulatory submissions in markets where cytisine is not yet approved.

How long did the research take and what stage is it at?

The project ran for 4 years (2015-2019) and is now closed. It progressed from development and feasibility through a full clinical trial to scale-up assessment. The intervention materials and trial results are complete and available.

Can this integrate with existing health systems?

That was the entire design philosophy — 'piggybacking' cessation onto existing TB control programs rather than building new infrastructure. The 6 work packages specifically studied how to deliver, sustain, and scale up within current TB clinic workflows in 3 countries.

Consortium

Who built it

The consortium brings together 10 partners across 6 countries, led by the University of York (UK). It includes 4 universities, 3 research organizations, 1 industry partner, and 2 other entities — giving it strong academic credibility but limited commercial muscle (only 10% industry ratio, zero SMEs). The geographic spread covers the 3 target countries (Bangladesh, Nepal, Pakistan) plus European research expertise (UK, Germany, Czech Republic). For a business looking to commercialize these findings, the lack of industry partners means there is open space for private-sector players to step in and drive market adoption of the intervention protocols and materials.

UNIVERSITY OF YORKCoordinator · UK
HEINRICH-HEINE-UNIVERSITAET DUESSELDORFparticipant · DE
VSEOBECNA FAKULTNI NEMOCNICE V PRAZEparticipant · CZ
UNIVERSITY OF LEEDSparticipant · UK
THE UNIVERSITY OF EDINBURGHparticipant · UK

How to reach the team

University of York, Department of Health Sciences — search for TB and Tobacco project lead

Order a report on this consortium See UNIVERSITY OF YORK profile →

Next steps

Talk to the team behind this work.

Want the full cost-effectiveness data or introduction to the research team? SciTransfer can arrange a direct briefing with the consortium.

Order a report on this topic More in Health & Biomedical