Introducing brief advice in tuberculosis services.

There are individual and contextual barriers to the adoption of new routines in health care. Health professionals working in tuberculosis (TB) care are unlikely to adopt smoking cessation interventions unless they understand the importance of such interventions, feel that doing them will produce results and are convinced that the interventions should be used. Health professionals need to know what they are expected to do and to feel they have the skills or tools necessary. But beyond informed, willing and ready health care providers, the health care service also needs to provide an encouraging infrastructure. Tobacco cessation has to be included in standard practice guidelines on TB case management, and information about smoking should be included in the standard monitoring process, with appropriate forms. Programme managers and technical advisors need to ask about, encourage and support the inclusion of smoking cessation interventions. It is advisable for one staff member to coordinate tobacco cessation activities to ensure that needed materials are available and to provide assistance and feedback to other staff.