Background:
Tobacco use exacerbates diseases, including tuberculosis (TB) and interferes with recovery from such outcomes. However, there is sparse research on the integration of tobacco cessation into TB programs. Moreover, there is limited evidence on how mHealth solutions for tobacco can enhance cessation among TB patients. This study aimed to assess the impact of a training program to integrate tobacco cessation in TB program on the knowledge of health workers.

Methods:
In June 2017, a 5-day training about tobacco use and control and the use of mHealth solutions to improve tobacco cessation and enhance adherence to TB treatment was conducted in Uganda. A comparison of percent of participants reporting knowledge on selected health outcomes of tobacco use and secondhand tobacco smoke (SHS) exposure was conducted. Knowledge was assessed on a 21-outcome-item before and after training. A non-parametric test, signrank for comparison of paired observations was conducted. The changes were considered statistically significant if the p-value was less than 5%.

Results:
Twenty three trainees from across the country attended (13 females, 10 males), with median age of the trainees was 39 years. Pre-training knowledge about tobacco use (66.6%) was higher than SHS exposure (45%). Following the training, both sets of knowledge significantly improved (median 100%). Pre-training knowledge about health effects of tobacco use was particularly low for diabetes (27%), meningitis (9.5%), ear infection (43%), impotence (47.6%), and fibrosis (30%). Except heart attack (76%), lung illness among children (91%), lung cancer (81%), and chronic lung disease (81%), pre-training knowledge about SHS was low for all other disease outcomes.

Conclusions:
Healthcare providers play critical role in preventing and reducing tobacco use. The low pre-training knowledge of the TB health workers suggests the critical need for training health providers in Uganda and elsewhere in Africa in order to curtail the increasing trend in usage.