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Hategeka C, Adu P, Desloge A, Marten R, Shao R, Tian M, Wei T, Kruk ME. Implementation research on noncommunicable disease prevention and control interventions in low- and middle-income countries: A systematic review. PLoS Med 2022; 19:e1004055. [PMID: 35877677 PMCID: PMC9359585 DOI: 10.1371/journal.pmed.1004055] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 08/08/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND While the evidence for the clinical effectiveness of most noncommunicable disease (NCD) prevention and treatment interventions is well established, care delivery models and means of scaling these up in a variety of resource-constrained health systems are not. The objective of this review was to synthesize evidence on the current state of implementation research on priority NCD prevention and control interventions provided by health systems in low- and middle-income countries (LMICs). METHODS AND FINDINGS On January 20, 2021, we searched MEDLINE and EMBASE databases from 1990 through 2020 to identify implementation research studies that focused on the World Health Organization (WHO) priority NCD prevention and control interventions targeting cardiovascular disease, cancer, diabetes, and chronic respiratory disease and provided within health systems in LMICs. Any empirical and peer-reviewed studies that focused on these interventions and reported implementation outcomes were eligible for inclusion. Given the focus on this review and the heterogeneity in aims and methodologies of included studies, risk of bias assessment to understand how effect size may have been compromised by bias is not applicable. We instead commented on the distribution of research designs and discussed about stronger/weaker designs. We synthesized extracted data using descriptive statistics and following the review protocol registered in PROSPERO (CRD42021252969). Of 9,683 potential studies and 7,419 unique records screened for inclusion, 222 eligible studies evaluated 265 priority NCD prevention and control interventions implemented in 62 countries (6% in low-income countries and 90% in middle-income countries). The number of studies published has been increasing over time. Nearly 40% of all the studies were on cervical cancer. With regards to intervention type, screening accounted for 49%, treatment for 39%, while prevention for 12% (with 80% of the latter focusing on prevention of the NCD behavior risk factors). Feasibility (38%) was the most studied implementation outcome followed by adoption (23%); few studies addressed sustainability. The implementation strategies were not specified well enough. Most studies used quantitative methods (86%). The weakest study design, preexperimental, and the strongest study design, experimental, were respectively employed in 25% and 24% of included studies. Approximately 72% of studies reported funding, with international funding being the predominant source. The majority of studies were proof of concept or pilot (88%) and targeted the micro level of health system (79%). Less than 5% of studies report using implementation research framework. CONCLUSIONS Despite growth in implementation research on NCDs in LMICs, we found major gaps in the science. Future studies should prioritize implementation at scale, target higher levels health systems (meso and macro levels), and test sustainability of NCD programs. They should employ designs with stronger internal validity, be more conceptually driven, and use mixed methods to understand mechanisms. To maximize impact of the research under limited resources, adding implementation science outcomes to effectiveness research and regional collaborations are promising.
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Affiliation(s)
- Celestin Hategeka
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Prince Adu
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Allissa Desloge
- School of Public Health, University of Illinois Chicago, Chicago, Illinois, United States of America
| | - Robert Marten
- Alliance for Health Policy and Systems Research, WHO, Geneva, Switzerland
| | | | - Maoyi Tian
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
- School of Public Health, Harbin Medical University, Harbin, China
| | - Ting Wei
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Margaret E. Kruk
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, Massachusetts, United States of America
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Mohamed R, Bullen C, Hairi FM, Nordin ASA. A systematic review of group therapy programs for smoking cessation in Asian countries. Tob Induc Dis 2021; 19:63. [PMID: 34413718 PMCID: PMC8336625 DOI: 10.18332/tid/140089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/26/2021] [Accepted: 07/08/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Tobacco causes more than 8 million deaths each year. Behavioral interventions such as group therapy, which provides counselling for smoking cessation, can be delivered in group form and smokers who receive cessation counselling are more likely to quit smoking compared to no assistance. We review the evidence of group-based counselling for smoking cessation for smokers in Asian countries. METHODS The review aims to determine the availability of group-based therapy for smoking cessation in Asian countries. The outcome measured was abstinence from smoking following group therapy. Electronic database searches in PubMed, OVID Medline, SCOPUS, Google Scholar, and PsycINFO, using keywords such as: ‘smoking’, ‘cigarette’, ‘tobacco’, ‘nicotine’, ‘group therapy’ and ‘cessation’ (smok*, *cigarette*, tobacco, nicotine, group therap*, cessation) were used. The results were reported following PRISMA and PROSPERO guidelines. Review Manager was used for data analysis. RESULTS A total of 21251 records were retrieved for screening the abstracts. In all, 300 articles for review were identified and assessed for eligibility. Nine articles, including Cochrane reviews, randomized control trials, cohort, observational and cross-sectional studies, were included in the final review. There were three observational qualitative studies, two prospective cohort studies, two crosssectional studies, one non-randomized quasi-experimental study and a single cluster-randomized, controlled trial. Group therapy was found to significantly increase the abstinence rate. Group therapy provided at the workplace, smoking cessation services, availability of pharmacotherapy, and socioeconomic status, appear to be key factors determining success. CONCLUSIONS Evidence of the use of group therapy for smoking cessation in Asian countries is still lacking despite publications in the Western population showed that group therapy was effective. Further research on group-based interventions for smoking cessation in Asian countries is required and direct one-to-one comparisons between group therapy and individual therapy for smokers who want to quit smoking, are needed.
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Affiliation(s)
- Rashidi Mohamed
- Department of Family Medicine, Faculty of Medicine, National University of Malaysia, Bangi, Malaysia
| | - Christopher Bullen
- National Institute for Health Innovation, School of Population Health, University of Auckland, Auckland, New Zealand
| | - Farizah Mohd Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amer Siddiq Amer Nordin
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.,University of Malaya Centre for Addiction Science Studies, Universiti Malaya, Kuala Lumpur, Malaysia
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Mandal G, Satyanarayana S, Dongre A, Mahalakshmy T, Gupte H. Assessing the outcome and influencing factors of a behavioral tobacco cessation intervention within a workplace setting: A mixed methods study. POPULATION MEDICINE 2021. [DOI: 10.18332/popmed/135443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Swain SK, Chatterjee K, Basannar DR. Efficacy of group intervention on tobacco cessation among male employees in health-care setting: A randomized controlled trial. Med J Armed Forces India 2021; 77:32-37. [PMID: 33487863 DOI: 10.1016/j.mjafi.2019.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 05/21/2019] [Indexed: 11/28/2022] Open
Abstract
Background The tobacco epidemic is one of the biggest public health threats the world has ever faced. World Health Organization has estimated that tobacco use (smoking and smokeless) is currently responsible for the death of about 7 million people across the world each year. The objective of the study was not only to find the effect of group intervention on tobacco cessation but also to describe certain epidemiological factors associated with tobacco cessation and make suitable recommendations to tackle this epidemic. Methods A randomized controlled trial was carried out among male employees who were tobacco users in health-care setting in Western Maharashtra. In the study, 60 subjects each in intervention and control arm were taken. Pretested validated questionnaires were used for the study. The intervention comprised of two sessions delivered 5 weeks apart. Control arm received self-help material (Booklet) immediately after baseline data collection. The outcomes were measured using structured interview schedule. The data were analyzed using SPSS, version 20. Results Overall, 13.3% of the study subjects had quit tobacco use post intervention. In the intervention group 21.7% of the participants had quit tobacco since past one month and 5% in the control group (relative risk (RR) = 4.33). Low to moderate nicotine dependence (p = 0.023, RR = 6.46) and stage of contemplation (p = 0.018) were found to be important predictors of abstinence. Conclusion Community-based group intervention for tobacco cessation is the way forward to tackle the tobacco epidemic.
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Affiliation(s)
- S K Swain
- Officer-in-Charge, Station Health Organisation, Visakhapatnam, India
| | - Kunal Chatterjee
- Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune, 411040, India
| | - D R Basannar
- Scientist 'F', Department of Community Medicine, Armed Forces Medical College, Pune 411040, India
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Mall A, Vyas S. Community-based interventional study for tobacco cessation in urban slums of Ahmedabad City: A cluster-randomized trial. Indian J Community Med 2021; 46:641-644. [PMID: 35068726 PMCID: PMC8729268 DOI: 10.4103/ijcm.ijcm_1016_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 08/09/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Materials and Methods: Results: Conclusion:
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Gupte HA, D'Costa M, Ramanadhan S, Viswanath K. Factors Influencing Implementation of a Workplace Tobacco Cessation Intervention in India: A Qualitative Exploration. Workplace Health Saf 2020; 69:56-67. [PMID: 33308086 DOI: 10.1177/2165079920952761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Tobacco use is projected to cause more than 8 million deaths annually worldwide by 2030 and is currently linked to 1 million annual deaths in India. Very few workplaces provide tobacco cessation as a part of occupational health in India. In this study, we examined promoters and barriers to implementing an evidence-based tobacco cessation program in a workplace setting in India. METHODS In-depth interviews were conducted with all facilitators (two program coordinators and four counselors) of a workplace tobacco cessation intervention covering implementation efforts in five organizations, including three manufacturing units and two corporate settings. FINDINGS The identified promoters for implementation of the program were as follows: (a) workplaces that provided access to many individuals, (b) high prevalence of tobacco use that made the intervention relevant, (c) core components (awareness sessions, face-to-face counseling and 6-months follow-up) that were adaptable, (d) engagement of the management in planning and execution of the intervention, (e) employees' support to each other to quit tobacco, (f) training the medical unit within the workplace to provide limited advice, and (g) efforts to advocate tobacco-free policies within the setting. Barriers centered around (a) lack of ownership from the workplace management, (b) schedules of counselors not matching with employees, (c) nonavailability of employees because of workload, and (d) lack of privacy for counseling. CONCLUSION/IMPLICATIONS FOR PRACTICE This study provided practical insights into the aspects of planning, engaging, executing and the process of implementation of a tobacco cessation intervention in a workplace setting. It provided guidance for an intervention within occupational health units in similar settings.
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Kar SS, Sivanantham P, Rehman T, Chinnakali P, Thiagarajan S. Willingness to quit tobacco and its correlates among Indian tobacco users-Findings from the Global Adult Tobacco Survey India, 2016-17. J Postgrad Med 2020; 66:141-148. [PMID: 32675450 PMCID: PMC7542056 DOI: 10.4103/jpgm.jpgm_408_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Willingness to quit in a tobacco user forms the basis for future quit attempts and quitting successfully. Objective To determine the prevalence and correlates of willingness to quit among tobacco users in India using the Global Adult Tobacco Survey (GATS), India, 2016-2017. Methods GATS, 2016-17 was a multistage geographically clustered sample survey done among 74,037 individuals aged 15 years and above across all the states and two of the Union Territories of India. Data of all those reported using any form of tobacco were studied for past attempts to quit tobacco, advised to quit by a health care provider, and exposure to anti-tobacco messages delivered through various media and the correlation of these with the willingness to quit using multivariate analysis. Results Of the 21,085 current tobacco users in the survey, 11,679 (52.2%), were willing to quit all forms of tobacco. Multivariate analysis showed that those in younger age groups (OR: 1.39 [1.23-1.56]), higher education levels (OR 1.15 [1.05-1.18]), time of first tobacco use in the day being more than 60 min after waking up in the morning (OR 1.11 [1.03-1.2]), history of attempts to quit in the past 12 months (OR 1.78 [1.69-1.87]), those advised to quit by health care provider in the past 12 months (OR 1.11 [1.06-1.17]), those using single form of tobacco (OR 1.1 [1.05-1.17]), those exposed to anti-tobacco messages in newspapers/magazines (OR 1.1 [1.05-1.17]), and cinemas (1.14 [1.08-1.20]) were more willing to quit compared to their counterparts. Conclusion Enhanced publicizing of anti-tobacco messages through the currently employed media, and ensuring that doctors give a brief advice to quit during any contact with a tobacco user could improve the willingness to quit and the consequent quit rate, especially among those tobacco users who are in younger age groups and who have attempted to quit earlier.
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Affiliation(s)
- S S Kar
- Department of PSM, JIPMER, Puducherry, India
| | | | - T Rehman
- Department of PSM, JIPMER, Puducherry, India
| | | | - S Thiagarajan
- Independent Consultant, Former Professor and Dean, TISS, Mumbai, Maharashtra, India
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Nagler EM, Aghi M, Rathore A, Lando H, Pednekar MS, Gupta PC, Stoddard AM, Kenwood C, Penningroth B, Sinha DN, Sorensen G. Factors associated with successful tobacco use cessation among teachers in Bihar state, India: a mixed-method study. HEALTH EDUCATION RESEARCH 2020; 35:60-73. [PMID: 31999824 PMCID: PMC6991618 DOI: 10.1093/her/cyz035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Abstract
Although tobacco use is declining in several countries including India (dropping from 35% in 2009-10 to 29% 2016-17 among adults)-it still poses a huge burden on India, as the world's second largest consumer of tobacco products. In Bihar state, with a prevalence of 25%, the Bihar School Teachers Study (BSTS) successfully enlisted teachers as role models for encouraging quitting and changing social norms pertaining to tobacco. The study used a mixed-methods approach to identify factors associated with teachers' quitting. Qualitative data were collected through focus groups with teachers and school principals. Quantitative data were collected through a written survey administered to school personnel post-intervention. Key findings from focus groups were that teachers and principals quit using tobacco and promoted cessation because they wanted to model positive behaviors; specific information about tobacco's harms aided cessation; and the BSTS intervention facilitated a school environment that supported quitting. Survey results indicated teachers who reported knowing people who quit using tobacco in the prior year were far more likely to quit as were teachers who reported that their school's tobacco policy was completely enforced. The combination of qualitative and quantitative data yielded important insights with strong implications for future interventions.
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Affiliation(s)
- E M Nagler
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, 450 Brookline Avenue, LW722 Boston, MA 02115, USA
| | - M Aghi
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra 400701, India
| | - A Rathore
- Welobaby Jaipur, Rajasthan 302039, India
| | - H Lando
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454, USA
| | - M S Pednekar
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra 400701, India
| | - P C Gupta
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra 400701, India
| | - A M Stoddard
- Biostatistical Consultant, Pelham, MA 01002, USA
| | - C Kenwood
- Veristat, LLC, Southborough, MA 01772, USA
| | | | - D N Sinha
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra 400701, India
| | - G Sorensen
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA 02215, USA
- Social and Behavioral Sciences Department, Harvard T.H. Chan School of Public Health, 450 Brookline Avenue, LW722 Boston, MA 02115, USA
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Gaikwad R, Bhowate R, Bajad P, Gadbail AR, Gondivkar S, Sarode SC, Sarode GS, Patil S. Potential Predictor of Tobacco Cessation among Factory Workers: A Baseline Data of Worksite Tobacco Cessation Programs in the Central Part of India. J Contemp Dent Pract 2017; 18:1071-1077. [PMID: 29109324 DOI: 10.5005/jp-journals-10024-2178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM Our study aimed to evaluate the prevalence of tobacco use among factory workers and identify the predicting factors for quitting tobacco use. MATERIALS AND METHODS In this cross-sectional study, a total of 640 factory workers were included and divided into the quitter group and who had never quit the tobacco habit in the past. Data were collected by standardized and validated questionnaire pro forma, which comprised the demographic profile, smoking history, and Fagerstrom scale to check the nicotine dependence. Data were analyzed using descriptive analysis and Chi-squares test, whereas logistic regression was used to predict the factor for quitting the tobacco habit. All tests were applied using Statistical Package for the Social Sciences (SPSS) version 17.0. RESULTS The mean age among the quitters was comparatively low than the never-quit group. Out of 640 participants, the majority of quitters and those who never quit were found to consume smokeless tobacco (232 [93.5]; 288 [73.5]). As per logistic regression analysis, gender of participants, age of starting tobacco use, and frequency of tobacco use can be considered as good predictors to quit smoking/chewing tobacco. CONCLUSION The present study found that participants in the quitter group were less dependent on tobacco, and these participants were more likely to quit smoking if behavioral support was provided at the early days of the quitting attempt. CLINICAL SIGNIFICANCE This study's result provides valuable insight into the current tobacco usage and potential predicting factors for quitting tobacco use among factory workers in India. These data can help in developing a policy for the implementation of tobacco cessation programs at the worksite.
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Affiliation(s)
- Rahul Gaikwad
- Department of Community Dentistry and Oral Epidemiology College of Dentistry, Qassim University, Buraydah, Kingdom of Saudi Arabia, Phone: +9545455848, e-mail:
| | - Rahul Bhowate
- Department of Oral Medicine and Radiology, Sharad Pawar Dental College, Wardha, Maharashtra, India
| | - Payal Bajad
- Department of Health and Medical Education, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
| | - Amol R Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra, India
| | - Shailesh Gondivkar
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Sachin C Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune Maharashtra, India
| | - Gargi S Sarode
- Department of Oral Pathology and Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pune Maharashtra, India
| | - Shankargouda Patil
- Department of Diagnostic Sciences, Division of Oral Pathology College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
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Sorensen G, Pednekar M, Cordeira LS, Pawar P, Nagler E, Stoddard AM, Kim HY, Gupta PC. Effects of a worksite tobacco control intervention in India: the Mumbai worksite tobacco control study, a cluster-randomised trial. Tob Control 2017; 26:210-216. [PMID: 26883793 PMCID: PMC4987266 DOI: 10.1136/tobaccocontrol-2015-052671] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 01/27/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We assessed a worksite intervention designed to promote tobacco control among workers in the manufacturing sector in Greater Mumbai, India. METHODS We used a cluster-randomised design to test an integrated health promotion/health protection intervention, the Healthy, Safe, and Tobacco-free Worksites programme. Between July 2012 and July 2013, we recruited 20 worksites on a rolling basis and randomly assigned them to intervention or delayed-intervention control conditions. The follow-up survey was conducted between December 2013 and November 2014. RESULTS The difference in 30-day quit rates between intervention and control conditions was statistically significant for production workers (OR=2.25, p=0.03), although not for the overall sample (OR=1.70; p=0.12). The intervention resulted in a doubling of the 6-month cessation rates among workers in the intervention worksites compared to those in the control, for production workers (OR=2.29; p=0.07) and for the overall sample (OR=1.81; p=0.13), but the difference did not reach statistical significance. CONCLUSIONS These findings demonstrate the potential impact of a tobacco control intervention that combined tobacco control and health protection programming within Indian manufacturing worksites. TRIAL REGISTRATION NUMBER NCT01841879.
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Affiliation(s)
- Glorian Sorensen
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Mangesh Pednekar
- Harvard T.H. Chan School of Public Health, Boston, MA
- Healis, Sekhsaria Institute for Public Health, Navi Mumbai, India
| | | | - Pratibha Pawar
- Healis, Sekhsaria Institute for Public Health, Navi Mumbai, India
| | - Eve Nagler
- Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA
- Harvard T.H. Chan School of Public Health, Boston, MA
| | | | | | - Prakash C. Gupta
- Harvard T.H. Chan School of Public Health, Boston, MA
- Healis, Sekhsaria Institute for Public Health, Navi Mumbai, India
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Binnal A, Rajesh G, Ahmed J, Denny C. Determinants of Smokeless Tobacco Consumption and its Cessation among its Current Users in India. J Clin Diagn Res 2016; 10:ZC103-ZC109. [PMID: 27891470 PMCID: PMC5121787 DOI: 10.7860/jcdr/2016/22704.8690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 08/31/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Global Smokeless Tobacco (SLT) consumption is on the rise and constitutes a major Public Health problem. Controlling SLT intake is central to containing the increasing tobacco menace. AIM The present study was undertaken to comprehensively explore various factors involved in SLT consumption and its cessation among current SLT users. MATERIALS AND METHODS Present study was conducted among current SLT users visiting Department of Oral Medicine and Radiology, Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore, Karnataka, India. A structured, pretested and self-administered questionnaire was employed for the present study. Knowledge, attitude, behaviour, worksite practices of respondents towards SLT consumption and its cessation, barriers to SLT cessation were explored. Information about socio-demographic variables was also collected. RESULTS Overall, 170 current SLT users participated in the present study. Results revealed that the mean knowledge, attitude, worksite related practices and barrier scores were 9.96(55.33%), 48.89(81.48%), 2.70(33.75%) and 54.25(60.27%) respectively. Correlation analysis revealed significant association of socio-demographic factors with knowledge, attitude and worksite related practices (p<0.05). SLT cessation related practices revealed that majority wished to quit (90%) and significant associations were noted amongst wish to quit with higher attitude scores; actual quit attempts with higher attitude, lower barrier scores and difficulty to quit with higher barrier scores (p<0.05). CONCLUSION The present study draws attention towards involvement of complex interactions of various parameters including socio-demographic factors in SLT consumption and its cessation. Hence, it is imperative to implement multifactorial SLT control approach in order to contain tobacco menace spread across the globe.
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Affiliation(s)
- Almas Binnal
- Reader, Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - G Rajesh
- Professor and Head, Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Junaid Ahmed
- Professor and Head, Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
| | - Ceena Denny
- Associate Professor, Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal University, Mangalore, Karnataka, India
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Maarof MF, Ali AM, Amit N, Bakry MM, Taha NA. Suitability of a Group Behavioural Therapy Module for Workplace Smoking Cessation Programs in Malaysia: a Pilot Study. Asian Pac J Cancer Prev 2016; 17:207-14. [PMID: 26838211 DOI: 10.7314/apjcp.2016.17.1.207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In Malaysia, data on components suitability the established smoking cessation module is limited. This exploratory study aimed to evaluate the suitability of the components developed in the module for group behavioural therapy in workplace smoking cessation programs. Twenty staff were identified but only eight individuals were selected according to the study criteria during the recruitment period in May 2014. Focus group discussion was conducted to identify themes relevant to the behavioural issues among smokers. Thematic analysis yielded seven major themes which were reasons for regular smoking, reasons for quitting, comprehending smoking characteristics, quit attempt experiences, support and encouragement, learning new skills and behaviour, and preparing for lapse/relapse or difficult situations. As a result, the developed module was found to be relevant and suitable for use based on these themes.
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Affiliation(s)
- Muhammad Faizal Maarof
- Faculty of Pharmacy, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia E-mail :
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Al-Bakri A, Jawad M, Salameh P, al'Absi M, Kassim S. Opportunistic insights into occupational health hazards associated with waterpipe tobacco smoking premises in the United Kingdom. Asian Pac J Cancer Prev 2015; 16:621-6. [PMID: 25684497 DOI: 10.7314/apjcp.2015.16.2.621] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smokefree laws aim to protect employees and the public from the dangers of secondhand smoke. Waterpipe premises have significantly increased in number in the last decade, with anecdotal reports of poor compliance with the smokefree law. The literature is bereft of information pertaining to waterpipe premise employees. This study aimed to opportunistically gather knowledge about the occupational health hazards associated with working in waterpipe premises in London, England. MATERIALS AND METHODS Employees from seven convenience-sampled, smokefree-compliant waterpipe premises in London were observed for occupational activities. Opportunistic carbon monoxide (CO) measurements were made among those with whom a rapport had developed. Observations were thematically coded and analysed. RESULTS Occupational hazards mainly included environmental smoke exposure. Waterpipe-serving employees were required to draw several puffs soon after igniting the coals, thereby providing quality assurance of the product. Median CO levels were 27.5 ppm (range 21-55 ppm) among these employees. Self-reported employee health was poor, with some suggestion that working patterns and smoke exposure was a contributory factor. CONCLUSIONS The smokefree law in England does not appear to protect waterpipe premise employees from high levels of CO. Continued concerns surrounding chronic smoke exposure may contribute to poor self-reported physical and mental wellbeing.
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Affiliation(s)
- Ali Al-Bakri
- Queen Mary, University of London, Barts and The London School of Medicine and Dentistry, Institute of Dentistry, London, UK E-mail :
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Dhumal GG, Pednekar MS, Gupta PC, Sansone GC, Quah ACK, Bansal-Travers M, Fong GT. Quit history, intentions to quit, and reasons for considering quitting among tobacco users in India: findings from the Tobacco Control Policy Evaluation India Wave 1 Survey. Indian J Cancer 2015; 51 Suppl 1:S39-45. [PMID: 25526247 DOI: 10.4103/0019-509x.147467] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Global Adult Tobacco Survey India 2009-2010 revealed that more than one-third (35%) of adults in India use tobacco in some form: 21% use smokeless tobacco, 9% smoke, and 5% are mixed users (they smoke and use smokeless tobacco), and the quit rate is very low. In an effort to decrease prevalence of tobacco use, it is thus important to understand the factors that are related to intention to quit among Indian tobacco users. Research has shown consistently that intention to quit is a strong predictor of future quitting. The present study reports the factors encouraging quitting tobacco products in India. SUBJECTS AND METHODS Cross-sectional data from Wave 1 of the International Tobacco Control Policy Evaluation India Survey conducted in four cities and surrounding rural areas (i.e. Mumbai [Maharashtra], Patna [Bihar], Indore [Madhya Pradesh], and Kolkata [West Bengal]) between August 2010 and December 2011 were analyzed. A total of 8051 tobacco users (15+ years) were randomly sampled from 8586 households: 1255 smokers, 5991 smokeless users, and 805 mixed (smoke and smokeless) users. Validated, standardized questions were asked about current tobacco use, intention to quit, and factors encouraging quitting. RESULTS Overall, 19.6% of tobacco users intended to quit. Smokers had less intention to quit as compared to smokeless tobacco users whereas mixed users had more intention to quit (odds ratio [OR] =1.48, 95% confidence interval [CI] =1.12-1.97) compared to smokeless tobacco users. Highly educated people were more likely to report intention to quit (OR = 1.82, 95% CI = 1.09-3.02) compared to less educated. Advice by doctors to quit tobacco had a strong impact on intention to quit (OR = 1.68, CI = 1.29-2.15). Tobacco users who were exposed to antitobacco messages at work places (OR = 1.74, CI = 1.23-2.46), at restaurants (OR = 1.65, CI = 1.12-2.43), bars (OR = 1.81, CI = 1.07-3.06), on public transportation (OR = 2.14, CI = 1.49-3.08) and on tobacco packages (OR = 1.77, CI = 1.29-2.14) also expressed greater intention to quit tobacco use. CONCLUSION Around one-fifth of tobacco users in India intended to quit tobacco use. Higher education, doctor's advice, and antitobacco messages were positively associated with users' intention to quit tobacco.
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Affiliation(s)
- G G Dhumal
- Healis Sekhsaria Institute for Public Health, Navi Mumbai, Maharashtra, India
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Anthony D, Dyson PA, Lv J, Thankappan KR, Fernández MT, Matthews DR. Reducing Health Risk Factors in Workplaces of Low and Middle-Income Countries. Public Health Nurs 2015; 32:478-87. [PMID: 25801204 DOI: 10.1111/phn.12189] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To reduce risk factors in workplace settings in low- and middle-income countries. DESIGN AND SAMPLE Workplace interventions were utilized as part of the Community Interventions for Health program, a nonrandomized, controlled study undertaken in three communities in China, India, and Mexico. Exactly, 45 industrial, 82 health and 101 school workplace settings with a target population of 15,726. Two independent cross-sectional surveys of workers were conducted at baseline and follow-up, after 18-24 months of intervention activities. MEASURES Culturally appropriate interventions to reduce tobacco use, increase physical activity, and improve dietary intake were delivered in the intervention areas. RESULTS Exactly, 12,136 adults completed surveys at baseline, and 9,786 at follow-up. In the intervention group, the prevalence of tobacco use reduced significantly in men (-6.0%, p < .001) and the proportion eating five portions of fruit and vegetables daily increased (+6.9%, p < .001) compared with the control group. There were no significant differences between the groups for changes in physical activity or prevalence of overweight. CONCLUSIONS Workplace interventions improved risk factors in China, India, and Mexico.
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Affiliation(s)
| | - Pamela A Dyson
- Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK
| | - Jun Lv
- School of Public Health, Peking University Health Science Center, Beijing, China
| | - Kavumpurathu R Thankappan
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | - David R Matthews
- Harris Manchester College, University of Oxford, Oxford, UK.,Oxford NIHR Biomedical Research Centre, Oxford, UK
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Jayakrishnan R, Uutela A, Mathew A, Auvinen A, Mathew PS, Sebastian P. Smoking cessation intervention in rural kerala, India: findings of a randomised controlled trial. Asian Pac J Cancer Prev 2014; 14:6797-802. [PMID: 24377608 DOI: 10.7314/apjcp.2013.14.11.6797] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND 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. 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. 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. 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). 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. CONCLUSIONS Rigorous approaches for smoking cessation programmes can enhance quit rates in smoking in rural areas of India.
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Savant SC, Hegde-Shetiya S, Agarwal D, Shirhatti R, Shetty D. Effectiveness of individual and group counseling for cessation of tobacco habit amongst industrial workers in pimpri, pune--an interventional study. Asian Pac J Cancer Prev 2014; 14:1133-9. [PMID: 23621201 DOI: 10.7314/apjcp.2013.14.2.1133] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In India, tobacco consumption is responsible for one of the highest rates of oral cancer in the world, the annual oral cancer incidence is steadily increasing among young tobacco users. Studies have documented efforts taken by physicians, doctors and even dentists, in the form of individual or group counseling to curb tobacco use in smoke or smokeless form. However, which one is more effective, still remains an unanswered question. The aim of the study was to compare the effectiveness of individual and group counseling for cessation of the tobacco habit amongst industrial workers in Pune and to compare quit rates. MATERIALS AND METHODS An interventional study design was selected for 150 industrial workers which were stratified randomly into three groups (control, individual and group counseling groups) and interventions were provided to individual and group counseling groups over a period of six months, which were then compared with the control group that received brief intervention at the start of the study. RESULTS There was significant difference in the quit rates of the participants in the individual counseling group (ICG) and group counseling group (GCG) when compared at 6 months with the control counseling group (CCG). In the individual counseling group was 6% while in group counseling group it was 7.5% after six months of counseling. CONCLUSIONS No conclusion could be drawn whether individual or group counseling were better interms of quit rates. Individual and group counseling groups were definitely better than the control group when compared at 3 and 6 months, respectively.
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DeAngelis MP, Burgel BJ. Snapshot of the AAOHN Membership—Health Risk Appraisal Priority Areas. Workplace Health Saf 2013; 61:237-42. [DOI: 10.1177/216507991306100601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A 2012 American Association of Occupational Health Nurses, Inc. (AAOHN) web-based membership survey of 5,138 members was designed to identify occupational health and safety issues facing members. A total of 2,123 members responded to the survey (41% response rate). Of the AAOHN members who responded to this survey, 61% reported health risk appraisal (HRA) priorities for 2012. HRA priority areas are identified among various subgroups of the AAOHN responders in this article. The top three HRA priority areas identified were weight management/nutrition/healthy eating, physical activity, and mental health/stress management. These priority areas were consistent across three industry sectors, three occupational health nurse job titles, and the smallest and largest employers. These results suggest that occupational health nurses should consider prioritizing their employee wellness efforts in these areas.
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DeAngelis MP, Burgel BJ. Snapshot of the AAOHN Membership— Health Risk Appraisal Priority Areas. Workplace Health Saf 2013. [DOI: 10.3928/21650799-20130529-79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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