Co-production of a National Botswana Tobacco Control Resource Center through Community Engagement Studio

Tobacco use causes over 8 million deaths annually, with low- and middle-income countries (LMICs) bearing most of the burden. In Botswana, tobacco use prevalence rose from 17.6% in 2017 to 22.2% in 2024. Despite this, tobacco control infrastructure remains limited. Tobacco Control Resource Centers (TCRCs) have been established to consolidate provider training, research, and dissemination of tobacco control resources. The World Health Organization (WHO) Centre for Tobacco Control in Africa (CTCA), a regional TCRC, has a cross-country mandate that could be further strengthened through complementary, country-specific support. We applied the Community Engagement Studio (CES) methodology to co-design of a Botswana-based TCRC-assessing acceptability, priorities, potential challenges, and implementation strategies. In July 2025, 12 stakeholders from the Botswana Smoking Abstinence Reinforcement Trial (BSMART), a NIH-funded study aimed at integrating smoking cessation interventions in HIV clinics, participated in a 2-hour CES. Stakeholders endorsed the need for a national TCRC, prioritizing provider training, dissemination, and cessation services. Sustainable financing emerged as a key challenge, prompting proposals for diversified funding models. We successfully conducted a CES to guide the co-design of a Botswana-based TCRC, illustrating the acceptability of a national TCRC and how CES can be leveraged to strengthen tobacco control infrastructure in Botswana.