PURPOSE Tobacco use is the leading cause of premature death worldwide. One aspect of tobacco control is convincing farmers to stop tobacco production. We assessed the willingness of tobacco farmers in Uganda to stop growing tobacco. METHODS We conducted a cross-sectional interview survey with an interviewer-administered questionnaire. Participants were active tobacco farmers in 12 villages of Kanungu district (N = 528) and were interviewed in 2013 to assess their willingness to stop growing tobacco. RESULTS Most farmers (61.7%) grew tobacco only as a cash crop with no supplemental income. A total of 198 farmers (37.5%) were willing to stop growing tobacco. Ninety-two respondents cited coffee as a potential replacement crop for tobacco and 106 mentioned rice. Barriers to growing replacement crops were that tobacco is highly profitable (n = 172) and that the soil (n = 175) and/or weather (n = 22) cannot sustain any crops other than tobacco. Willingness to stop growing tobacco was 1.32 times as likely among farmers who said that tobacco use causes respiratory diseases and 1.16 times as likely among farmers who received less than less than $300 USD from tobacco sales in the previous season. Agreeing that tobacco is profitable decreased the likelihood of willingness to stop growing tobacco by 36%. CONCLUSION Only one in three farmers were willing to stop growing tobacco. To increase their willingness to stop growing tobacco, farmers must be educated on the health consequences of tobacco and we must demonstrate to farmers that other crops may be more profitable than tobacco.

10 Background: Tobacco use is the leading cause of premature death and disability in both developed and developing countries. One aspect of tobacco control is convincing farmers to stop tobacco production. Because tobacco is a key contributor to the agricultural economy of many communities, we explored the conflict between tobacco production and public health in the current study. This project aims to assess the willingness of tobacco farmers in Uganda to stop growing tobacco. Methods: A cross-sectional interview survey was conducted with an interviewer administered questionnaire. Participants in the study were active tobacco farmers in 12 villages of Kanungu district (n = 528) and were interviewed in May and June of 2013 to assess their willingness to stop growing tobacco. Results: Most farmers (61.7%) grew tobacco only as a cash crop and had no supplemental income. A total of 198 (37.5%) of the farmers were willing to stop growing tobacco. Ninety-two respondents mentioned coffee as a replacement for tobacco and 106 mentioned rice. Barriers for replacement were that tobacco is highly profitable (n=172) and that the soil (n=175) and or weather (n=22) cannot sustain any other crop besides tobacco. Willingness to stop growing tobacco was more likely among farmers who said that tobacco use causes respiratory diseases and who received less than less than $300 U.S. dollars from tobacco sales in the previous season. On the other hand, agreeing that tobacco is profitable decreased the likelihood of willingness to stop growing tobacco. Conclusions: Most farmers earned income from tobacco only, and one in three were willing to stop growing tobacco. In order to increase willingness to stop growing tobacco, there is a need to educate farmers on health consequences of tobacco and increase the perception among farmers that other crops may be more profitable than tobacco. These measures should target farmers who receive more money from tobacco sales. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: No COIs from either author.