On average, how many of the following do you smoke each day? Manufactured

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6. Do you currently use any smokeless tobacco such as snuff, chewing tobacco,

betel? 6b. If yes, do you currently use smokeless tobacco products daily? 7. On average, how many times a day do you use… RECORD FOR EACH TYPE Because tobacco is used in a variety of forms, it is essential to assess the use of smoke- less tobacco particularly in settings where smokeless tobacco is preferred to smoked tobacco. In some countries of the African and Eastern Mediterranean Regions, the use of tobacco products such as chewing tobacco, water pipes, narguileh or sheesha often surpass cigarette smoking. STEPS฀implementation฀at฀country฀level he ultimate goal of the STEPS approach is to increase a country’s capacity to devel- op a sustainable infrastructure for NCD surveillance 3. To achieve this, strategic alliances are necessary at the global, regional and country level Figure 2. WHO headquarters provides global coordination for implementing STEPS across the WHO regions. WHO headquarters, in collaboration with the WHO regional offices, pro- vides STEPS training to STEPS focal points by region and country. he WHO STEPS training utilizes a “train the trainer” approach, ensuring that knowledge transfer and capacity is improved and maintained at country level. Train- ing covers all aspects of the planning, implementation, data collection, analysis and dissemination of the results of a STEPS survey within the context of an integrated surveillance system. WHO regional offices implement the programmes within coun- tries and organize the training workshops. Current฀status Currently, STEPS is being carried out in four WHO regions, namely the WHO Afri- can Region, the WHO Eastern Mediterranean Region, the WHO South-East Asia Region and the WHO Western Pacific Region, and covers over 35 countries. Over 50 countries have been trained in regional training workshops as well as national work- shops. Practical฀considerations •฀ Each WHO Member State implementing STEPS is advised to convene a group or a committee, which works as the equivalent of national inter-agency coordinating committee Figure 2. his committee should oversee the practical and logistic is- sues relating to the overall country level implementation of STEPS, as well as pro- viding assistance in translating data into policy and programmes. •฀ he data collected must be relevant for the development of public health interven- tions. •฀ he collection and analysis of good quality data are not enough to inform policy in an environment in which the health agenda is subject to competing priorities. herefore, it is necessary to further provide policy-makers with accurate, useful and easily interpreted results. he STEPS approach was designed with this fact in mind