Innovative Interprofessional Approach Using Service Training to Enable a Fisher Folk Community to Quit Tobacco Habits

Abstract

Background and context: Fisher folk use tobacco products to avoid sea sickness and to stay awake during night, while working at sea. They have minimal education, low income and are unaware of harmful effects of tobacco. It has also been observed that the prevalence of oral precancerous lesions and conditions are high in this community. The present dental curriculum does not emphasize on training undergraduates on antitobacco counseling. Aim: To assess the effectiveness of interprofessional initiative using service training to enable a fisher folk community to quit tobacco habits. Strategy/Tactics: Dentists are in a strategic position to diagnose oral cancerous and precancerous lesions and facilitate tobacco cessation. As tobacco addiction is based on physical, psychological and behavioral factors, it could be managed through multisectoral approach by interprofessional collaboration. Involvement of primary health care workers and community leaders will ensure reinforcement and sustainability of the desired effects in the community. Program/Policy process: A training module was formulated by an interprofessional team consisting of psychiatrist, public health dentist and tobacco interventionists. Thirty dental interns and three primary health workers participated in training program on lifestyle of fisher folk, tobacco epidemic, harmful effects of tobacco use and tobacco cessation. The interns were also trained for role play in local language, conveying the same message which empowered them to conduct awareness programs in the community there after. A house to house survey was conducted by primary health workers in 308 houses of the community to assess knowledge and attitude of fisher folk toward tobacco use before and after tobacco intervention program by interns. Outcomes: There was highly significant increase in knowledge and skills of dental interns after training program. Thirty seven percent of current tobacco users in the community decided to quit the habit and there was 52% increase in the number of smoke free homes in the community, three months after tobacco awareness programs were conducted in the community. What was learned: The interprofessional initiative empowered interns to incorporate tobacco cessation in routine dental practice and effectively enabled fisher folk community in adopting smoke free home policy.