Adapting and implementing very brief advice+ (VBA+) in primary care to promote adolescent smoking cessation in Kyrgyzstan: A mixed-methods FRESHAIR4Life study

Introduction

Tobacco-related morbidity and mortality are increasingly shifting toward low- and middle-income countries (LMICs), with most smokers beginning during adolescence. In Kyrgyzstan, adolescent-specific cessation services are not yet systematically integrated into primary care. This study aimed to culturally and contextually adapt Very Brief Advice Plus (VBA+) to the local context, implement the intervention, and evaluate healthcare professionals' implementation behaviors and determinants following training.