Determinants of Quit Attempts and Short-Term Abstinence among Smokeless Tobacco Users in India: Global Adult Tobacco Survey, 2016-17.

Abstract

Smokeless tobacco is the preponderant form of tobacco in India. The cessation indicators are weaker for smokeless tobacco users than smokers. There is a dearth of literature on the effectiveness of the interventions that motivate and assist smokeless tobacco users in quitting in program settings. Data from Global Adult Tobacco Surveys (GATS), 2016-17, was analysed. Quit attempts in the previous 12 months among SLT users and duration of abstinence were the two outcome variables. The chief exposure variables were the receipts of various interventions that warned about the dangers of smokeless tobacco or encouraged quitting. Logistic regression analyses were employed to identify determinants of quit attempts. For the hazard of relapse to tobacco use, survival analysis was used. The odds of quit attempts among SLT users in the previous 12 months were more among those who received advice from healthcare providers (OR 2.09; 1.87-2.34), noticed messages from media that made them think about quitting (OR 1.67; 1.50-1.86) and noticed a warning label that made them think about quitting (OR 1.39; 1.25-1.55). Those who used counselling (HR 0.81; 0.70-0.93) or medication (HR 0.79; 0.66-0.95) sustained abstinence from smokeless tobacco for a longer duration compared to those who did not use any cessation method. Quit advice by healthcare providers is an influential determinant of a quit attempt, and this intervention needs to be scaled up. The media messages and warning labels were effective among those who considered quitting after noticing them. Cessation methods can help prolong the abstinence from smokeless tobacco, but the reach of cessation methods is limited.