Abstract
Background: Tobacco epidemic is one of the biggest public health threats, killing nearly seven million people annually. With implementation of smoke free public places legislation, cabs in India are smoke free. However, large majority of the cab drivers are addicted to tobacco. Aim: The aims of the study were to measure cab driver's knowledge, about tobacco, understand pattern of tobacco usage, provide assistance in quitting tobacco, perform oral cancer screening, measure effectiveness of smoking ban in cabs and understand perceptions of cab drivers and commuters to ban. Methods: 400 cab drivers in Mumbai were enrolled after obtaining informed consent. Personal interviews were conducted to understand their knowledge, attitudes and practices regarding tobacco use, smoke free cab policies and their experiences and opinion regarding ban on smoking in cabs. They were offered health education, oral cancer screening and tobacco cessation assistance at regular intervals over a year. Results: 64% cab drivers used tobacco, mainly in smokeless forms (80%). 94% intended to quit, 64% had made previous quit attempts and 70% expressed need of assistance for quitting tobacco. 62% had displayed a No Smoking sign in their cab and 75% expressed full compliance by passengers to the ban. 112 cab drivers had oral precancerous lesions and one cab driver was diagnosed with invasive oral carcinoma. 49% cab drivers quit tobacco and 46% reduced their tobacco consumption by the end of ten months. Conclusion: Smoke free cab policy has increased awareness and reduced passive smoking and this may encourage tobacco users to quit the habit. However, many cab drivers are themselves addicted to tobacco and need professional assistance for quitting. Hence, tobacco cessation - assisting the current users to quit tobacco needs to go hand in hand with smoke free policies. Smoke free cab policies have received enormous support from the cab drivers in Mumbai. There was encouraging compliance to smoke free policies from the commuters. Tobacco quit rate of 49% was achieved by the end of the program.
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