- Volume 14 Issue 11
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Smoking Cessation Intervention in Rural Kerala, India: Findings of a Randomised Controlled Trial
- Jayakrishnan, Radhakrishnan (School of Health Sciences, University of Tampere) ;
- Uutela, Antti (National Institute For Health and Welfare) ;
- Mathew, Aleyamma (Regional Cancer Centre) ;
- Auvinen, Anssi (School of Health Sciences, University of Tampere) ;
- Mathew, Preethi Sara (Regional Cancer Centre) ;
- Sebastian, Paul (Regional Cancer Centre)
- Published : 2013.11.30
Background: Prevalence of tobacco use is higher in the rural than urban areas of India. Unlike tobacco cessation clinics located in urban areas, community-based smoking cessation intervention has the potential to reach a wider section of the community to assist in smoking cessation in the rural setting. The present study aimed to assess the effectiveness of a cessation intervention in rural Kerala state, India. Materials and Methods: Current daily smoking resident males in the age group 18-60 years from four community development blocks in rural Kerala were randomly allocated to intervention and control groups. The intervention group received multiple approaches in which priority was given to face-to-face interviews and telephone counselling. Initially educational materials on tobacco hazards were distributed. Further, four rounds of counselling sessions were conducted which included a group counselling with a medical camp as well as individual counselling by trained medical social workers. The control group received general awareness training on tobacco hazards along with an anti-tobacco leaflet. Self-reported smoking status was assessed after 6 and 12 months. Factors associated with tobacco cessation were estimated using binomial regression method. Results: Overall prevalence of smoking abstinence was 14.7% in the intervention and 6.8% in the control group (Relative risk: 1.85, 95% CI: 1.05, 3.25). A total of 41.3% subjects in the intervention area and 13.6% in the control area had reduced smoking by 50% or more at the end of 12 months. Lower number of cigarettes/ bidi used, low nicotine dependence and consultation with a doctor for a medical ailment were the statistically significant predictors for smoking cessation. Conclusions: Rigorous approaches for smoking cessation programmes can enhance quit rates in smoking in rural areas of India.
Community approach;intervention;smoking cessation;rural Kerala;India
- Aveyard P, Raw M (2012). Improving smoking cessation approaches at the individual level. Tob Control, 21, 252-7. https://doi.org/10.1136/tobaccocontrol-2011-050348
- Ferguson JA, Patten CA, Schroeder DR, et al (2003). Predictors of 6-month tobacco abstinence among 1224 cigarette smokers treated for nicotine dependence. Addict Behav, 28, 1203-18. https://doi.org/10.1016/S0306-4603(02)00260-5
- Ferlay J, Shin HR, Bray F, et al (2010) GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10.Lyon, France: International Agency for Research on Cancer; 2010.
- Fiore MC, Jaen CR, Baker BT, et al (2008). Treating tobacco use and dependence: 2008 update Clinical Practice Guideline. Rockville. MD: US Dept of Health and Human Services; 2008.
- Hyland A, Li Q, Bauer JE, et al (2004). Predictors of cessation in a cohort of current and former smokers followed over 13 years. Nicotine Tob Res, 6, 363-9. https://doi.org/10.1080/14622200412331320761
- Hymowitz N, Cummings KM, Hyland A, et al (1997). Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tob Control, 6, 57-2. https://doi.org/10.1136/tc.6.suppl_2.S57
- International Institute for Population Sciences (2010). Global Adult Tobacco Survey India (GATS India), 2009-10. Ministry of Health and Family Welfare, Government of India, 1-7.
- Jayakrishnan R, Mathew A, Uutela A, et al (2011). A community based smoking cessation intervention trial for rural Kerala, India-preliminary results. Asian Pac J Cancer Prev, 12, 3191-5.
- Jayakrishnan R, Mathew A, Kamala L, et al (2012). Assessment of nicotine dependence among smokers in a selected rural population in Kerala, India. Asian Pac J Cancer Prev, 13, 2663-7. https://doi.org/10.7314/APJCP.2012.13.6.2663
- Jayakrishnan R, Mathew A, Uutela A, et al (2013). Multiple approaches and participation rate for a community based smoking cessation intervention trial in Rural Kerala, India. Asian Pac J Cancer Prev, 14, 2891-6. https://doi.org/10.7314/APJCP.2013.14.5.2891
- Jha P (2009). Avoidable global cancer deaths and total deaths from smoking. Nat Rev Cancer, 9, 655-64. https://doi.org/10.1038/nrc2703
- Kumar MS, Sarma PS, Thankappan KR (2012) Community-based group intervention for tobacco cessation in rural Tamil Nadu, India: a cluster randomized trial. J Subst Abuse Treat, 43, 53-60. https://doi.org/10.1016/j.jsat.2011.10.026
- Lancaster T, Stead LF (2005) Individual behavioural counselling for smoking cessation. Cochrane Database Syst Rev, 2, 1292.
- Mackay J, Eriksen M (2002). The tobacco atlas. Geneva: World Health Organization.
- Mackay J, Eriksen M, Shafey O (2006). The Tobacco Atlas 2nd edition. Atlanta: American Cancer Society, 1106-7.
- Ministry of Health and Family Welfare, Government of India. The Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act, 2003.
- Mooney ME, Johnson EO, Breslau N, et al (2011). Cigarette smoking reduction and changes in nicotine dependence. Nicotine Tob Res, 13, 426-30. https://doi.org/10.1093/ntr/ntr019
- Murthy P, Sadicha S (2010). Tobacco cessation services in India. Recent developments and the need for expansion. Indian J Cancer, 47, 69-74. https://doi.org/10.4103/0019-509X.63873
- Noronha V, Dikshit R, Raut N, et al (2012). Epidemiology of lung cancer in India: Focus on the differences between non-smokers and smokers: a single-centre experience. Indian J Cancer, 49,74-81. https://doi.org/10.4103/0019-509X.98925
- Pimple S, Pednekar M, Mazumdar P, et al (2012). Predictors of quitting tobacco-results of a worksite tobacco cessation service program among factory workers in Mumbai, India. Asian Pac J Cancer Prev, 13, 533-8. https://doi.org/10.7314/APJCP.2012.13.2.533
- Richter KP, McCool RM, Okuyemi KS, et al (2002). Patients' views on smoking cessation and tobacco harm reduction during drug treatment. Nicotine Tob Res, 4, 175-82. https://doi.org/10.1080/1462220021000032735
- Sinha DN, Dobe M (2004). Effectiveness of tobacco cessation intervention programmes. Indian J Public Health, 48, 138-43.
- Thankappan KR, Mini GK, Daivadanam M et al (2013). Smoking cessation among diabetes patients: results of a pilot randomized controlled trial in Kerala, India. BMC Public Health, 13, 47. https://doi.org/10.1186/1471-2458-13-47
- Thun MJ, DeLancey JO, Center MM, et al (2010). The global burden of cancer: priorities for prevention. Carcinogenesis, 31, 100-10. https://doi.org/10.1093/carcin/bgp263
- Tobacco Smoke and Involuntary Smoking (2004). Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans. IARC, 83, 1452.
- Effect on Smoking Quit Rate of Telling Smokers their Health Risk Appraisal in Terms of Health Age: A Randomized Control Trial vol.15, pp.12, 2014, https://doi.org/10.7314/APJCP.2014.15.12.4963
- How Compliant are Tobacco Vendors to India's Tobacco Control Legislation on Ban of Advertisments at Point of Sale? A Three Jurisdictions Review vol.15, pp.24, 2015, https://doi.org/10.7314/APJCP.2014.15.24.10637
- Biomarkers of Response to Smoking Cessation Pharmacotherapies: Progress to Date vol.29, pp.5, 2015, https://doi.org/10.1007/s40263-015-0243-1
- Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications vol.12, pp.7, 2017, https://doi.org/10.1371/journal.pone.0180640