Abstract
Tobacco use and quit attempts are two key indicators of the Global Adult Tobacco Survey (GATS) that assess quit attempts among current as well as former tobacco users. The relevant data have inherent policy implications for tobacco cessation programme evaluation. This study aimed to review the concepts of quit attempt assessment and quantifying invalid responses considering GATS-India data. GATS assessment of tobacco use and quit attempts were examined in the current literature. Two categories of invalid responses were identified by stratified analysis of the duration of last quit attempt among current users and duration of abstinence among former users. Category A included absolute invalid responses when time- frame of assessment of current tobacco use and less than former tobacco use were violated. Category B included responses that violated the unit of measurement of time. Current daily use, current less than daily use and former use in GATS were imprecisely defined with overlapping of time-frame of assessment. Overall responses of 3,102 current smokers, 4,036 current smokeless users, 1,904 former smokers and 1,343 former smokeless users were analyzed to quantify invalid responses. Analysis indicated overall 21.2% (category A: 7.32%; category B: 17.7%) and 22.7% (category A: 8.05%; category B: 18.1%) invalid responses among current smokers and smokeless users respectively regarding their duration of last quit attempt. Similarly overall 6.62% (category A: 4.7%; category B: 2.3%) and 10.6% (category A: 8.6%; category B: 3.5%) invalid responses were identified among former smokers and smokeless users respectively regarding their duration of abstinence. High invalid responses for a single assessment are due to the imprecise definition of current use, former use and quit attempt; and failure to utilize opportunity of direct data entry interface use during the survey to validate responses instantly. Redefining tobacco use and quit attempts considering an appropriate timeframe would reduce invalid responses.
Highlights
Quit attempt among tobacco users is an important tobacco cessation behaviour indicator (Starr et al, 2005; Fong et al, 2006; Global Adult Tobacco Survey Collaborative Group, 2011)
This study aimed to review the concepts of quit attempt assessment and quantifying invalid responses considering Global Adult Tobacco Survey (GATS)-India data
Analysis indicated overall 21.2% and 22.7% invalid responses among current smokers and smokeless users respectively regarding their duration of last quit attempt
Summary
Quit attempt among tobacco users is an important tobacco cessation behaviour indicator (Starr et al, 2005; Fong et al, 2006; Global Adult Tobacco Survey Collaborative Group, 2011) It has been defined as an activity by a tobacco user in which the person tries to quit (stop using) with the intention of never using it again (IARC, 2008). Various key indicators have been defined for population level monitoring and evaluation of tobacco cessation/ control programs, which include classification of smokers by intention and attempts to quit smoking (WHO, 1998; Giovino et al, 2009). Quit attempt assessment is a key indicator in GATS to assess tobacco cessation behaviour among current and former users (IIPS, 2010; Global Adult Tobacco Survey Collaborative Group, 2011). The objective of this study is to examine conceptual issues and validity of responses with the GATS assessment of quit attempt
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