Implementing Prevention against Tobacco Dependence (PAD) "Toward the Tobacco-Free Schools, Neighborhoods, and Cities": Study Protocol

Background: Although tobacco consumption in Iran has decreased in recent years, in 2010, the exposure to cigarette smoke was the fifth leading risk factor for death in Iran. This article is presenting the protocol for the prevention against tobacco dependence (PAD) project, an initiative planned and implemented by the Iranian Anti-Tobacco Association (IATA) of Iran in the city of Varamin.Study design: A prospective cohort study.Methods: This project is carried out based on a participatory community-oriented approach and an action research method. It includes four inter-related, prospective studies phases; pilot, tobacco-free school (TFS), tobacco-free neighborhood (TFN), and tobacco-free city (TFS). The measuring tools for each phase were designed primarily using CDC and WHO guidelines and preliminary details were identified. Each phase is a combination of different methods (including systematic observation, questionnaire, heuristic interview, and structured interview). The studies will examine twelve goals and meet 9 project objectives in a comprehensive evaluation of ongoing progress with TFS, TFN, and TFC.Discussion: This project seeks to achieve indicators of tobacco-free schools, neighborhoods, and cities through direct and indirect education of all the target groups in the community. Participation of stakeholders and supporters in problem-solving can increase the effectiveness and influence of the project. The outcomes of the first two phases will be expanded to the wider settings.