Abstract
Smokeless tobacco use in South Asia is believed to be a significant contributor to morbidity and mortality. In India, only a few studies involving health educational intervention by health care providers have demonstrated reduction in smokeless tobacco usage. In the present study we assessed the cessation efforts towards smokeless tobacco by physicians in two high tobacco prevalence states of India. The study also identified opportunities and barriers for integration of tobacco cessation services in routine practices of physicians. This mixed method study involved qualitative (phase I) and quantitative research study (phase II). In phase I, 59 in-depth interviews with physicians were conducted. In phase II, a quantitative study conducted among 238 physicians. An inductive approach was followed to analyze qualitative data using ATLAS. Ti software. The Chi-square test was employed to test the association between different variables of interest using SPSS version 17. The majority of physicians related only respiratory problems and cancer with smokeless tobacco. Other major health effects like cardio-vascular problems, oral diseases, and effects on reproductive and neonatal health were recognized only by a few physicians. The age-group of 10-19 years was identified as most vulnerable to smokeless tobacco use. Less than one-third of physicians reported recording smokeless tobacco history of all patients. Findings indicated that less than half of physicians provided information on harmful health effects of smokeless tobacco with regard to specific diseases. The study revealed a low level of knowledge of physicians about harmful effects of tobacco and their suboptimal engagement in tobacco control practices. The study indicates the need of capacity building initiatives to equip physicians with skills in tobacco cessation.
Highlights
Tobacco use is the leading preventable cause of death
Majority of physicians were interviewed at Primary Health Centres (PHC) in rural areas
Knowledge of physicians on health effects of smokeless tobacco: Table 2 shows that majority of physicians related only respiratory problems and cancer with smokeless tobacco
Summary
Tobacco use is the leading preventable cause of death. Globally, tobacco accounts for over 5 million deaths annually. Smokeless tobacco use in South Asia is believed to be a significant contributor to morbidity and mortality (Gupta and Ray, 2003). Increasing use of smokeless tobacco has been reported among men, and among vulnerable groups such as children, adolescents, and women of reproductive age (GATS India, 2009-10; Patel, 2012). Smokeless tobacco use in South Asia is believed to be a significant contributor to morbidity and mortality. In India, only a few studies involving health educational intervention by health care providers have demonstrated reduction in smokeless tobacco usage. The study identified opportunities and barriers for integration of tobacco cessation services in routine practices of physicians. Findings indicated that less than half of physicians provided information on harmful health effects of smokeless tobacco with regard to specific diseases. The study indicates the need of capacity building initiatives to equip physicians with skills in tobacco cessation
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