Lung Diseases LD16, 2017 – 2017

An integrated health-sector strategy to combat COPD and asthma in Vietnam: A pragmatic stepped intervention cluster randomized trial

Funding amount



5 years


Chronic lung disease is a mounting health priority for Vietnam, with over 10% of the population suffering from either COPD or asthma (1, 2), and three out of every four adult males having a history of smoking (3). Evidence-based interventions to prevent (4) and reduce the burden of chronic obstructive lung disease (OLD) (5) are well-established internationally, however such strategies currently reach only a small proportion of the most vulnerable populations in this resource-limited setting. Furthermore, a lack of local evidence has deterred policy-makers from applying these approaches (6).

Aims & objectives

Co-primary objective

(A) To determine the effect of a smoking cessation intervention upon the rate of sustained abstinence among smokers after two years; (B) To evaluate the effectiveness of an integrated SC and ICS intervention upon the proportion of individuals with one or more exacerbations of COPD or asthma within two years of follow-up;

Secondary objectives:

  • To determine the effect of the combined intervention upon all-cause mortality
  • To determine physician and patient compliance with a structured clinical decision algorithm for patients with persistent and/or recurrent respiratory symptoms.
  • To conduct a cost-effectiveness analysis of smoking cessation among smokers, and the combined intervention among patients with OLD.
  • To evaluate the knowledge, attitudes and beliefs of patients and health care workers regarding smoking cessation and ICS use before and after the intervention.
  • To disseminate findings: engaging local and national policy-makers in translating the established protocols into practice and policy.


  1. Lam HT, Ekerljung L, NF TFSTN, et al. Prevalence of COPD by disease severity in men and women in northern Vietnam. COPD. 2014;11(5):575-81.
  2. Lim S, et al. Impact of chronic obstructive pulmonary disease in the Asia-Pacific region: the EPIC Asia population-based survey. Asia Pac Fam Med. 2015;14(1):4.
  3. Bui TV, Blizzard L, Luong KN, et al. Declining Prevalence of Tobacco Smoking in Vietnam. Nicotine tobacco research. 2015 Jul;17(7):831-8.
  4. Willemse BW, et al. The impact of smoking cessation on respiratory symptoms, lung function, airway hyperresponsiveness and inflammation. Eur Respir J. 2004;23(3):464-76.
  5. Yang IA, Clarke MS, Sim EH, et al. Inhaled corticosteroids for stable chronic obstructive pulmonary disease. Cochrane DB Syst Rev. 2012;7:CD002991.
  6. Higashi H, Khuong TA, Ngo AD, et al. Evidence and decision making: tobacco control policy and legislation in Vietnam. Int J Health Plan M. 2013 Jan-Mar;28(1):e72-94.

Principal Investigator

Gregory Fox, University of Sydney, Australia

Funding organisations

  • Lung Diseases LD16
  • Vietnam
  • 2017 – 2017