Abstract

To determine whether screening, brief intervention, and referral for treatment can reduce the prevalence of tobacco use in rural and semi-rural settings. A non-randomized clinical trial with assessments at baseline and post-intervention assessments at 3 and 6 months was conducted in a rural and semi-rural district in South-West of Nigeria. A representative sample of 1203 persons consented to the study and had alcohol, smoking, and substance involvement screening test (ASSIST) administered to them by trained community health-care extension workers between October 2010 and April 2011. Follow-up participation was more than 99% at all points. Participants received a single ASSIST-linked brief intervention (BI) and referral for treatment (RT) at entry, and a booster ASSIST BI and RT at 3 months. The primary outcome was self-reported scores on ASSIST. At baseline, out of 1203 respondents, lifetime prevalence and current prevalence of any tobacco products were 405 (33.7%) and 248 (20.6%), respectively. Of the current users, on the ASSIST, 79 (31.9%) scored 0-3 (low health risk), 130 (52.4%) scored 4-26 (moderate risk), and 39 (15.7%) scored 27+ (high risk). At 3 months, out of 1199 respondents, prevalence of current users was 199 (16.5%) and out of 1195 respondents, was 169 (14.1%) at 6 months. Prevalence of tobacco use reduced significantly at 3 months Z = -3.1, p = 0.01 and at 6 months when compared with baseline Z = 4.2, p = 0.001, but not at 6 months compared with at 3 months, Z = 2.1, p = 0.09. Multivariate analysis revealed that age at initiation of tobacco use, gender, marital status, setting of dwelling, and socioeconomic status were the only variables that were associated with current tobacco use at baseline, 3 and 6 months. A one-time BI with a booster at 3 months had a significant effect on tobacco use in persons living in community settings. This finding suggests a need for promoting the adoption of this intervention for tobacco use in rural and semi-rural community settings.

Highlights

  • While globalization of the use of cigarette and other products of tobacco is a major threat to public health worldwide [1, 2], studies have noted the decline in tobacco use in high-income countries and an increase in use in middle- and low-income countries [3, 4]

  • In the Western world, the provision of SBIRT as a form of smoking cessation intervention is generally toward treatment seeking smokers [22]. In developing countries such as Nigeria, where the majority live in rural settings, and access to medical care is limited to urban centers, smoking cessation treatment may not be offered until tobacco-related disease is detected or until the smoker expresses interest in quitting

  • We found that the current prevalence of tobacco use was 20.6% at baseline

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Summary

Objective

Brief intervention, and referral for treatment can reduce the prevalence of tobacco use in rural and semi-rural settings. Method: Design and participants: A non-randomized clinical trial with assessments at baseline and post-intervention assessments at 3 and 6 months was conducted in a rural and semi-rural district in South-West of Nigeria. Intervention: Participants received a single ASSIST-linked brief intervention (BI) and referral for treatment (RT) at entry, and a booster ASSIST BI and RT at 3 months. Prevalence of tobacco use reduced significantly at 3 months Z = −3.1, p = 0.01 and at 6 months when compared with baseline Z = 4.2, p = 0.001, but not at 6 months compared with at 3 months, Z = 2.1, p = 0.09. Multivariate analysis revealed that age at initiation of tobacco use, gender, marital status, setting of dwelling, and socioeconomic status were the only variables that were associated with current tobacco use at baseline, 3 and 6 months

INTRODUCTION
MATERIALS AND METHODS
Study Design
Procedure
RESULTS
DISCUSSION
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