- Volume 13 Issue 12
DOI QR Code
Health System Preparedness for Tobacco Control: Situational Analysis of Existing Health Programs in Andhra Pradesh, India
- Panda, Rajmohan (Health System Reseach, Public Health Foundation of India) ;
- Mathur, Manu Raj (Health System Reseach, Public Health Foundation of India) ;
- Divya, Persai (Health System Reseach, Public Health Foundation of India) ;
- Srivastava, Swati (Health Economics, Project STEPS, Public Health Foundation of India) ;
- Ramachandra, Srikrishna Sulgodu (Indian Institute of Public Health)
- Published : 2012.12.31
Introduction: Andhra Pradesh (AP) is one of the largest tobacco producing states in India. About 29% of adults in AP currently use tobacco in some form. Almost 24% of males and 4% of females are smokers. The prevalence of tobacco use in the state is higher than the national average of 15% for male and 2% for female smokers. However, few attempts have been made to understand the current situation of tobacco control resources, activities and strategies in the context of such a high tobacco prevalence state. The present study aimed to identify the gaps in existing tobacco control program and areas where tobacco control efforts can be integrated. Methods: Data were collected using both quantitative and qualitative methods. Semi-structured interviews were undertaken with a total of 95 key officials of state health departments, program managers, and project directors in six districts to understand ongoing tobacco control efforts. To facilitate the interviews, semi-structured guides were developed. Simple descriptive statistical analysis was conducted on the quantitative data using SPSS version 17. Results: The results of the situational analysis suggest that a sufficient health workforce and infrastructure with the potential to integrate tobacco control activities is available in the surveyed districts. However, lack of integration of the tobacco control program intothe tuberculosis control program and the National Rural Health Mission was observed. Information, education and communication activities were lacking at block level health facilities. Conclusions: Our findings indicate that lack of trained health professionals, paucity of dedicated funds, lack of information, education and communication materials and low priority given to tobacco control activities are some of the factors which impede integration of tobacco control into existing health and developmental programmes in the districts of Andhra Pradesh, India.
Situational analysis;tobacco control programme;Andhra Pradesh;India
- Government of India (2007). National Tobacco Control Programme, 2007-08. Ministry of Health and Family Welfare, India. Available from: http://www.mohfw.nic.in
- International Agency for Research on Cancer (2004). IARC Monographs on the Evaluation of the carcinogenic risk of chemicals to humans. Tobacco smoke and involuntary smoking. 83. Lyon: IARC Press.
- Lasker RD, Weiss ES (2003). Broadening participation in community problem solving: a multidisciplinary model to support collaborative practice and research. J Urban Hlth, 80, 14-47.
- Madan Kumar PD, Poorni S, Ramachandran S (2006). Tobacco use among school children in Chennai city. Indian J Cancer, 43, 127-13. https://doi.org/10.4103/0019-509X.27935
- Ministry of Health and Family Welfare (2009). Global Youth Tobacco Survey (GYTS), 2009. Available from: http://www.whoint/tobacco/survelliance/gyts/en
- Ministry of Health and Family Welfare: Global Adult Tobacco Survey (GATS) India report 2009-10.India: Ministry of Health and Family Welfare, 2009-10. Available from:http:// whoindia.org/LinkFiles/Tobacco_Free_Initiative_GATS2010_Chapter-08.pdf
- Ministry of Health and Family Welfare. National Cancer Control Programme. Available from: http://mohfw.nic.in/showfile.php?lid=324
- Murray CJ, Lopez AD (1996). The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Cambridge, Massachussets: Harvard School of Public Health.
- Rahman M, Fukui T (2005). Bidi smoking and health. Public Hlth, 114, 123-7.
- Ratcliffe J, Cairns J, Platt S (1997). Cost effectiveness of a mass media-led anti-smoking campaign in Scotland. Tob Control, 6, 104-10. https://doi.org/10.1136/tc.6.2.104
- Reddy KS, Gupta PC (2005). Report on Tobacco Control in India. Ministry of Health and Family Welfare, New Delhi, India.
- SK Jindal, SK Malik, R Dhand, et al (1982). Bronchogenic carcinoma in Northern India. Thorax, 37, 343-7. https://doi.org/10.1136/thx.37.5.343
- WHO Regional Office for South East Asia (2009). Effective Implementation of the WHO Framework Convention on Tobacco Control through the MPOWER Policy Package. Geneva: World Health Organization. Available from: http://www.searo.who.int/LinkFiles/Tobacco_Free_Initiative_ NL_vol_2_no_2.pdf
- World Health Organization (2008). 2008-2013 Action plan for the global strategy for the prevention and control of noncommunicable diseases.
- World Health Organization (2002). Executive summary: national cancer control programmes: policies and managerial guidelines. Geneva: WHO; 2002. Available from:. http://www.who.int/ cancer.
- World Health Organization (2010). Global Status Report on Non Communicable Diseases. Geneva.
- Bhonsle RB, Mutri PR, Gupta PC (1992). Tobacco habits in India. In: Gupta PC, Hamner JE III, Murti PR, eds (1992). Control of Tobacco-Related Cancers and Other Diseases. NY: Oxford University Press Inc, 25-46
- Butterfoss FD, Goodman RM, Wandersman A (1996). Community coalitions for prevention and health promotion: factors predicting satisfaction, participation, and planning. Hlth Education Q, 23, 65-79. https://doi.org/10.1177/109019819602300105
- Centre for Disease Control and Prevention (2007). Best Practices for Comprehensive Tobacco Control Programs Atlanta: U.S. Department of Health and Human Services, Centres for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Available from: http://www.cdc.gov/tobacco/tobacco_control_programs/stateandcommunity/ best_practices/
- Centers for Disease Control and Prevention (2011). Tobacco Use and Pregnancy: Home. What do we Know about Tobacco Use and Pregnancy. Available from: http://www.cdc.gov/ reproductivehealth/tobaccousepregnancy/
- Fiore MC, Jaen CR, Baker TB, et al (2008).Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville, MD: US Department of Health and Human Services, Public Health Service.
- Gajalakshmi V, Peto R, Kanaka TS, Jha P (2003). Smoking and mortality from tuberculosis and other diseases in India: Retrospective study of 43000 adult male deaths and 35000 controls. Lancet, 362, 507-15. https://doi.org/10.1016/S0140-6736(03)14109-8
- A Cross-Country Comparison of Knowledge, Attitudes and Practices about Tobacco Use: Findings from the Global Adult Tobacco Survey vol.15, pp.12, 2014, https://doi.org/10.7314/APJCP.2014.15.12.5035
- Missed opportunities for brief intervention in tobacco control in primary care: patients’ perspectives from primary health care settings in India vol.15, pp.1, 2015, https://doi.org/10.1186/s12913-015-0714-6