Abstract
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. 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. 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. Rigorous approaches for smoking cessation programmes can enhance quit rates in smoking in rural areas of India.
Highlights
It has been estimated that, approximately 180 million tobacco related deaths can be avoided, if tobacco consumption among adults can be reduced to 50% by the year 2020 (Mackay and Eriksen, 2002)
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 quit rates achieved in this study were comparatively high when compared to a study conducted in Bihar state of India where identified volunteers were trained to give community cessation activities resulting in 4% quit rate and 2% dose reduction rate (Sinha and Dobe, 2004)
Summary
It has been estimated that, approximately 180 million tobacco related deaths can be avoided, if tobacco consumption among adults can be reduced to 50% by the year 2020 (Mackay and Eriksen, 2002). It is an established fact that 55% of total lung cancer deaths are reported from developing countries annually (Ferlay et al, 2010). Prevalence of tobacco use is higher in the rural than urban areas of India. 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. 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).
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