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Kandasamy G, Sam G, Almanasef M, Almeleebia T, Shorog E, Alshahrani AM, Almohaimeed RA, Hmlan A, Al Suhaym AY, Prabahar K, Veeramani VP, Amirthalingam P, Mohammed Shorog B, Mani V. A study on the prevalence of smoking habits among the student community in Aseer Region, Saudi Arabia. Front Public Health 2023; 11:1257131. [PMID: 38186697 PMCID: PMC10766698 DOI: 10.3389/fpubh.2023.1257131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/28/2023] [Indexed: 01/09/2024] Open
Abstract
Objectives A cross-sectional study was aimed to assess the prevalence of smoking habits among students at King Khalid University (KKU), Abha, KSA. Methods This was a cross-sectional study using a Modified Fagerstrom Tolerance Questionnaire (mFTQ), online survey was carried out among the students of KKU. This tool uses a five-point Likert scale for all seven questions, except one question on smoking during the first 2 h of the day. Results The prevalence of smoking among male students was 67% (n = 243) and females 33% (n = 122). Of the current cigarette smokers, 19% had a nicotine dependence score of ≥6 (high), 48% scored 4-6 (moderate) and 33% scored <4 (minimal). Association between mFTQ and the number of cigarettes per day (p < 0.001), first smoke of your cigarettes (p < 0.018), smoking in the morning (p < 0.007), and difficulty refraining from smoking in public areas (p < 0.000). The results of the current study recommend that cigarette smoking habits are a significant risk behavior among young students. The strength of this study signifies that most participants (62%) intend to quit if appropriately supported. Conclusion According to the findings of the current investigation, smoking was quite common among males. It raises the alarm about the critical need for adequate education to support health education initiatives, discourage teen smoking, and enhance health outcomes for the community.
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Affiliation(s)
- Geetha Kandasamy
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Gigi Sam
- Department of Pharmaceutical Sciences, College of Pharmacy, Shaqra University, Dawadmi, Saudi Arabia
| | - Mona Almanasef
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Tahani Almeleebia
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Eman Shorog
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Asma M. Alshahrani
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Rana A. Almohaimeed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Amjad Hmlan
- Department of Clinical Pharmacy, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | - Atheer Y. Al Suhaym
- Eradah Hospital for Mental Health in Jazan, Ministry of Health, Jazan, Saudi Arabia
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Vinoth Prabhu Veeramani
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | | | - Basmah Mohammed Shorog
- Department of Family and Community Medicine, Armed Forces Hospital Southern Region, Khamis Mushait, Saudi Arabia
| | - Vasudevan Mani
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah, Saudi Arabia
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Timilsina JK, Bhatta B, Devkota A. Nicotine dependence and quitting stages of smokers in Nepal: A community based cross-sectional study. PLoS One 2022; 17:e0266661. [PMID: 35395045 PMCID: PMC8993023 DOI: 10.1371/journal.pone.0266661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/19/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Nicotine dependence is an addiction to tobacco products caused by the chemical nicotine present in tobacco. 80% of premature deaths due to nicotine dependence come from low-and middle-income countries. Since most of the public health studies have focused solely on psychological and behavioral factors associated with tobacco smoking, this study aims to assess the nicotine dependence and stages of change of quitting smoking. METHODOLOGY A community based quantitative cross-sectional study was conducted among 280 smokers aged 15-69 years in Bharatpur metropolitan, Nepal. A semi-structured and validated questionnaire was used during the face-to-face interviews. Nicotine dependence among participants was assessed using the six-item Fagerstrom Test for Nicotine Dependence (FTND). Chi-square test and multivariate logistic regression analysis were performed to assess the associations between variables at the significance level α = 0.05. RESULT In the study population, the mean score of FTND was 5.15 ± 2.34. 33.9% participants had a high level of nicotine dependence and nearly half of the participants felt difficulty to refrain smoking even in No-smoking areas. Almost three out of ten respondents were prepared for smoking cessation. It was found that age group 20-39 years were more likely to have nicotine dependence (AOR 3.308, 95% CI = 1.039-10.534), those who initiated smoking before age of 15 were associated with a greater risk of nicotine dependence (AOR 3.68, 95% CI = 1.826-7.446), participants spending more on tobacco products (more than Rs 2400 monthly) were associated with an increased risk of nicotine dependence (AOR 4.47, 95% CI = 2.225-8.991), those who initiated smoking due to mental stress were more likely to have nicotine addiction (AOR 2.522, 95% CI = 1.004-6.028), and those who had no thought of quitting smoking were more associated with nicotine dependence (AOR 4.935, 95% CI = 1.458-16.699). CONCLUSION Our study showed that high level of nicotine dependence is a major public health problem in low-and middle-income countries like Nepal. It also highlights that effective smoking cessation programs should be developed considering the level of nicotine dependence with more focus on early interventions of its associated factors.
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Affiliation(s)
- Janaki Kumari Timilsina
- Bachelor of Public Health Program, School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
| | - Bimala Bhatta
- School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
| | - Amrit Devkota
- BP Koirala Institute of Health Sciences, Dharan, Nepal
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Sharma MK, Suman LN, Srivastava K, Suma N, Vishwakarma A. Psychometric properties of Fagerstrom Test of Nicotine Dependence: A systematic review. Ind Psychiatry J 2021; 30:207-216. [PMID: 35017802 PMCID: PMC8709504 DOI: 10.4103/ipj.ipj_51_21] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/24/2021] [Accepted: 06/01/2021] [Indexed: 11/25/2022] Open
Abstract
The Fagerstrom test for nicotine dependence (FTND) is a widely used test for assessing physical nicotine dependence. However, there is a need to assess the psychometric properties of FTND to assess its role in treatment outcome studies. The aim of the present investigation was to review the psychometric properties of the FTND. A broad systematic literature search was performed from Pubmed and PsycINFO from 2000 to 2019. The publication language was limited to English. Two review authors performed the study selection and extracted the data. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Rayyan software used to screen relevant studies. A total of 1471 articles retrieved from the search, of which 33 studies fulfilled the inclusion criteria. Eleven studies related to testing the reliability of the FTND were analyzed. Twenty-five studies evaluated the Cronbach alpha of the test. Analysis of the studies revealed the questionable psychometric qualities of the adapted versions of the test across different cultures and ethnicity. It also suggested that it may not tap the appropriate constructs that would predict smoking patterns in light smokers, e-cigarette smokers, and smokeless tobacco users. Thus, further research must focus on improving the psychometric properties of FTND to enhance the measurement of nicotine dependence.
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Affiliation(s)
- Manoj Kumar Sharma
- SHUT Clinic (Service for Healthy Use of Technology), Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - L N Suman
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Kalpana Srivastava
- Department of Psychiatry, Defence Research and Development Service, Armed Forces Medical College, Pune, Maharashtra, India
| | - N Suma
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
| | - Akash Vishwakarma
- Department of Clinical Psychology,National Institute of Mental Health and Neuro Sciences, Bengaluru, Karnataka, India
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Acharya S, Acharya S, Pentapati KC, Thomson WM. Nicotine dependence and its association with health utility ratings among a sample of Indian dental patients. Community Dent Oral Epidemiol 2021; 49:574-580. [PMID: 33638567 DOI: 10.1111/cdoe.12629] [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: 06/04/2020] [Revised: 01/12/2021] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To measure utility ratings and quality-adjusted life-years(QALYs) for nicotine dependence-related health states using the standard gamble approach among a sample of dental patients; investigate the possible associations of nicotine dependence, and study the influences on tobacco-related health state utilities estimates among patients. METHODS A sample of 200 adult outpatients who were current or former consumers of tobacco were included in the cross-sectional study. Demographic, oral health self-rating and tobacco-related data (Fagerstrom scale for nicotine dependence, type of tobacco consumed, frequency and duration of the habit) were collected. A standard gamble method of utility valuation was also carried out. RESULTS Older age, lower educational attainment, higher frequency of consumption, increased duration of the habit, consumption of chewing tobacco, as opposed to smoking tobacco, and poor oral health were associated with higher nicotine dependence. Lower nicotine dependence, better oral health and quitting the habit were associated with better health utility estimates. QALYs lost due to the habit among the 'low to moderate' and 'significant' nicotine dependence groups were 2.7 (sd, 3.7) and 6.7 (sd, 8.0) years, respectively. CONCLUSIONS Higher health utility ratings were seen among patients with 'low to moderate' nicotine dependence, better oral health status and quitters of the tobacco habit. Quality of life weights generated through this method could be used for cost-utility analyses of tobacco cessation/prevention interventions in different settings and cultures.
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Affiliation(s)
- Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Shruthi Acharya
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - Kalyana Chakravarthy Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, India
| | - William Murray Thomson
- Dental Epidemiology and Public Health, Faculty of Dentistry, WHO Collaborating Centre for Dental Epidemiology and Public Health, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Rao D, Gaur T, Jadhav A, Dagur L, Dhaka H, Pathak P, Chhabra K. Nicotine dependence, perceived stress, and self-efficacy among primary health care professionals during the times of Covid-19 pandemic – A cross-sectional descriptive study. J Family Med Prim Care 2021; 10:4124-4130. [PMID: 35136777 PMCID: PMC8797112 DOI: 10.4103/jfmpc.jfmpc_629_21] [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: 04/02/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Nicotine dependency would have increased during the times of COVID-19 among the primary health professionals, which would can be attributed to perceived stress and can also be influenced by self-efficacy; hence, the aim of the present study was to determine the relationship between nicotine dependence with perceived stress, self-efficacy among primary health care professionals during the times of covid-19 pandemic. Materials and Methods: The present study was a cross-sectional descriptive questionnaire study. The study was conducted among primary health workers of Ajmer district; stratified random sampling technique was used to collect data. A questionnaire was prepared that consists of demographic details, questions on perceived stress, self-efficacy, and nicotine dependence. Results: Perceived stress and nicotine dependence was high among study participants. Self-efficacy was low. There was significant (P ≤ 0.05) association between high nicotine dependence and high perceived stress. It was also reported that majority of study participants {58 (30.4%)} with high self-efficacy significantly (P ≤ 0.05) was associated with low nicotine dependence. Conclusion: High nicotine dependence was significantly associated with high perceived stress, while low nicotine dependence was significantly lower among primary health care workers’ low perceived stress. Low nicotine dependence was significantly associated among study participants with high self-efficacy.
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Islam K, Datta AK, Seth S, Roy A, Das R. A study on the prevalence and correlates of nicotine dependence among adolescents of Burdwan Town, West Bengal. Indian J Psychiatry 2019; 61:89-93. [PMID: 30745660 PMCID: PMC6341911 DOI: 10.4103/psychiatry.indianjpsychiatry_112_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Tobacco will cause one billion deaths in the 21st century. The use of tobacco causes dependence both psychological and physical. AIMS To find out the level of nicotine dependence and it correlates among adolescents. SETTINGS AND DESIGN A community-based, cross-sectional, observational study was conducted in the Burdwan town, West Bengal, among 1354 adolescent tobacco users. MATERIALS AND METHODS Data were collected by direct interview using a pretested, predesigned, semistructured schedule containing the Fagerström Test for Nicotine Dependence (FTND) questionnaire. STATISTICAL ANALYSIS Pearson's Chi-square test, Student's unpaired t-test, one-way analysis of variance, Pearson's product-moment correlation coefficient, and multivariable linear regression were used. All the statistical analyses were performed using SPSS version 19.0. RESULTS The mean FTND score was significantly higher among adolescents aged >15 years, males, Hindu, tobacco users from joint family, who belonged to lower socioeconomic status, who started using tobacco at the age of 10-12 years, using tobacco for ≥5 years, who were not married, were illiterate, working, and not aware of the injurious effect of tobacco to health. CONCLUSIONS A suitable individualized approach should be used for those who want to quit tobacco depending on their FTND score.
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Affiliation(s)
- Kamirul Islam
- Department of Pediatrics, Burdwan Medical College, Burdwan, West Bengal, India
| | - Asok Kumar Datta
- Department of Pediatrics, Burdwan Medical College, Burdwan, West Bengal, India
| | - Soutrik Seth
- Department of Pediatrics, Burdwan Medical College, Burdwan, West Bengal, India
| | - Atanu Roy
- Department of Pediatrics, Burdwan Medical College, Burdwan, West Bengal, India
| | - Rajib Das
- Department of Pediatrics, Burdwan Medical College, Burdwan, West Bengal, India
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Singh A, Katyan H. Classification of nicotine-dependent users in India: a decision-tree approach. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0973-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Svicher A, Cosci F, Giannini M, Pistelli F, Fagerström K. Item Response Theory analysis of Fagerström Test for Cigarette Dependence. Addict Behav 2018; 77:38-46. [PMID: 28950117 DOI: 10.1016/j.addbeh.2017.09.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The Fagerström Test for Cigarette Dependence (FTCD) and the Heaviness of Smoking Index (HSI) are the gold standard measures to assess cigarette dependence. However, FTCD reliability and factor structure have been questioned and HSI psychometric properties are in need of further investigations. The present study examined the psychometrics properties of the FTCD and the HSI via the Item Response Theory. METHODS The study was a secondary analysis of data collected in 862 Italian daily smokers. Confirmatory factor analysis was run to evaluate the dimensionality of FTCD. A Grade Response Model was applied to FTCD and HSI to verify the fit to the data. Both item and test functioning were analyzed and item statistics, Test Information Function, and scale reliabilities were calculated. Mokken Scale Analysis was applied to estimate homogeneity and Loevinger's coefficients were calculated. RESULTS The FTCD showed unidimensionality and homogeneity for most of the items and for the total score. It also showed high sensitivity and good reliability from medium to high levels of cigarette dependence, although problems related to some items (i.e., items 3 and 5) were evident. HSI had good homogeneity, adequate item functioning, and high reliability from medium to high levels of cigarette dependence. Significant Differential Item Functioning was found for items 1, 4, 5 of the FTCD and for both items of HSI. CONCLUSIONS HSI seems highly recommended in clinical settings addressed to heavy smokers while FTCD would be better used in smokers with a level of cigarette dependence ranging between low and high.
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Vinoth Kumar NM, Khijmatgar S, Chowdhury C. Interrelations of Level of Urinary Cotinine and Score for Fagerstrom Test for Nicotine Dependence among Beedi Smokers, and Smokeless Tobacco Users in India. Indian J Psychol Med 2017; 39:392-398. [PMID: 28852228 PMCID: PMC5559982 DOI: 10.4103/0253-7176.211758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Tobacco related diseases is largely preventable and can stop pre-mature death. According to World Health Organization (WHO), the prevalence rate of smoking is 28.6% (40% among males and 18.2% among females).[1] Beedismoking and tobacco chewing are the commonest forms of tobacco habits in India, and strongly associated with oral cancer in India.[2] There are methods to estimation of severity of tobacco dependency, of them FTND is identified. The score for FTND is used for cigarette smoking, but we do not know the FTND score of ST users and Beedi smokers in India. Therefore, keeping the study in plan, we aim a systemic review with the following objective. OBJECTIVES 1. To pursue a review of published researches on interrelations between Beedi smoking and FTND score. 2. To pursue a review of published researches on interrelations between consumption of ST and FTND score. MATERIALS AND METHODS A systematic search of published papers were examined from three different electronic databases namely Pubmed, Cochrane library, and ProQuest. The inclusion criteria and exclusion criteria was set based on commonality of the studies which was looked through the objectives. Total of four papers of its category were found, and those met the criteria for inclusion factors. RESULTS Seventy-one articles were screened initially and forty-three articles were excluded and twenty-eight articles were screened, out of which twenty articles were excluded based on inclusion criteria. The abstracts of remaining eight articles were reviewed and four were removed because of duplication of the data. Finally, four articles were included for review after three stages of screening. Review results revealed that out of four selected reviews, one research study finding was interrelated with FTND score and Beedi and ST users. This study results also revealed that there is not a set of research carried out on FTND score for Beedi smokers and ST users.
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Affiliation(s)
- Nalini M Vinoth Kumar
- Department of Psychiatric Nursing, Nitte Usha Institute of Nursing Sciences, Nitte University, Mangalore, Karnataka, India
| | - Shahnawaz Khijmatgar
- Department of Oral Biology and Genomic Studies, A.B. Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, Karnataka, India
| | - Chitta Chowdhury
- Department of Oral Biology and Genomic Studies, A.B. Shetty Memorial Institute of Dental Sciences, Nitte University, Mangalore, Karnataka, India
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Saha I, Islam K, Paul B, Som TK. Nicotine dependence and its correlates among the adult tobacco users in a slum of Burdwan district, West Bengal, India. J Family Med Prim Care 2017; 6:813-818. [PMID: 29564269 PMCID: PMC5848404 DOI: 10.4103/jfmpc.jfmpc_42_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Tobacco kills half of its users, with smoking and smokeless tobacco killing nearly 6 million people worldwide - one death every 6 s in each year. Use of tobacco over time causes a physical and psychological addiction due to the presence of nicotine. To find out the level of nicotine dependence among adult (18 years and above) tobacco users and the factors responsible for it. Materials and Methods A cross-sectional community-based study was conducted among 128 current tobacco users in an urban slum of Burdwan District, West Bengal, India. Study tools comprised of predesigned, pretested, semi-structured schedule, containing Fagerström test for nicotine dependence (FTND) questionnaire. Data were collected by interview after getting consent from the participants. Chi-square test, unpaired student t-test, ANOVA, correlation coefficient, and linear regression was calculated. SPSS software (Statistical Package for the Social Sciences Inc, Chicago, IL, USA). was used for analysis. Results High level of nicotine dependence was maximally seen among increased in age group, prolonged duration of use and daily users. Age, duration of tobacco use and habit of tobacco use had a significant positive correlation with FTND score while starting age of tobacco had a significant negative correlation. Then in multivariable linear regression, starting age of tobacco use, habit of tobacco use and duration of tobacco use emerged as a significant predictor of FTND score and could explain 27.3% of total variation in FTND score. Conclusions Suitable plan for quitting may be developed based on the FTND score of an individual, the most important determinant of quitting.
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Affiliation(s)
- Indranil Saha
- Department of Community Medicine, IQ City Medical College, Durgapur, West Bengal, India
| | - Kamirul Islam
- Department of Paediatric Medicine, Burdwan Medical College and Hospital, Burdwan, West Bengal, India
| | - Bobby Paul
- Department of Preventive and Social Medicine, All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
| | - Tapas Kumar Som
- Department of Community Medicine, IQ City Medical College, Durgapur, West Bengal, India
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Divinakumar KJ, Patra P, Prakash J, Daniel A. Prevalence and patterns of tobacco use and nicotine dependence among males industrial workers. Ind Psychiatry J 2017; 26:19-23. [PMID: 29456316 PMCID: PMC5810161 DOI: 10.4103/ipj.ipj_14_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Tobacco use is an important preventable health risk factor in India. AIM This study was carried out to estimate the prevalence of current tobacco use, factors and extent of dependence associated with its use among male workers of an industrial organization. MATERIALS AND METHODS A total of 759 participants randomly selected from the population of employees were administered questionnaire in Hindi containing demographic profile, patterns of smoking, and use of smokeless tobacco and alcohol. RESULTS Forty-one percent of the surveyed males (n = 750) used tobacco either by smoking or smokeless method or both (9.7% used both, 23.4% smoked, and 27.3% used smokeless tobacco). The maximum percentage was among the 26-30 years' age group, and the married persons (45.4%, OR = 2.17, P < 0.05). Tobacco use was associated with lower educational qualifications, history of tobacco use in family members, and drinking alcohol. Seventy-two percent of the nicotine users reported being influenced by their peers in initiating the habit, 59.4% of the users reported being advised to stop tobacco use by a health professional, and 52.9% had attempted quitting the habit more than once. Twenty percent of our sample were dependent on nicotine and the highest prevalence was seen in those using both smoking and the smokeless tobacco. CONCLUSIONS The Prevalence of Tobacco Use and Nicotine Dependence among male industrial employees is significant and necessitates Tobacco awareness and cessation programs regarding Tobacco use.
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Affiliation(s)
- K J Divinakumar
- Deaprtment of Psychiatry, Command Hospital, Kolkata, West Bengal, India
| | - P Patra
- Deaprtment of Psychiatry, Command Hospital, Kolkata, West Bengal, India
| | - Jyoti Prakash
- Deaprtment of Psychiatry, Command Hospital, Kolkata, West Bengal, India
| | - Arun Daniel
- Officer Commanding, Station Health Organization, Golconda Cantonment, Hyderabad, India
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Jena PK, Bandyopadhyay C, Mathur MR, Das S. Extending application of the 'hardcore' definition to smokeless tobacco use: estimates from a nationally representative population in India and its implications. Asian Pac J Cancer Prev 2016; 13:5959-63. [PMID: 23464385 DOI: 10.7314/apjcp.2012.13.12.5959] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The term 'hardcore' has been applied to use of smoking tobacco and generally referred to as the inability or unwillingness of regular smokers to quit. The component constructs of hardcore except nicotine dependence are product neutral. With the use of 'time to first chew' as a measure of nicotine dependence, hardcore definition can be extended to characterize smokeless tobacco users. Hardcore users respond less to tobacco cessation interventions, and are prone to tobacco induced diseases including cancer. Thus identifying hardcore users would help in estimate the burden of high risk population for tobacco induced diseases. Smokeless tobacco use is predominant and accounts for more than 50% of oral cancer in India. Hence, hardcore chewing information could be used for planning of tobacco and cancer control interventions. The objective of this study was to assess the prevalence and associated factors of hardcore smokeless tobacco use in India. MATERIALS AND METHODS Global Adult Tobacco Survey (GATS)-India 2010 data were analyzed to quantify hardcore smokeless tobacco use in India with following five criteria: (1) current daily smokeless tobacco use; (2) no quit attempt in the past 12 months of survey or last quit attempt of less than 24 hours duration; (3) no intention to quit in next 12 months or not interested in quitting; (4) time to first use of smokeless tobacco product within 30 minutes of waking up; and (5) knowledge of smokeless tobacco hazards. RESULTS The number of hardcore smokeless tobacco users among adult Indians is estimated to be 5% (39.5 million). This group comprises 23.2% of daily smokeless tobacco users. The population prevalence varied from 1.4-9.1% across different national regions of India. Logistic regression modeling indicated age, education and employment status to be the major predictors of hardcore smokeless tobacco use in India. CONCLUSIONS The presence of a huge number (39.5 million) of hardcore smokeless tobacco users is a challenge to tobacco control and cancer prevention in India. There is an unmet need for a universal tobacco cessation programme and intensification of anti-tobacco education in communities.
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Aryal UR, Bhatta DN, Shrestha N, Gautam A. Assessment of nicotine dependence among smokers in Nepal: a community based cross-sectional study. Tob Induc Dis 2015; 13:26. [PMID: 26309428 PMCID: PMC4549004 DOI: 10.1186/s12971-015-0053-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 08/20/2015] [Indexed: 11/25/2022] Open
Abstract
Background The Fagerström Test for Nicotine Dependence (FTND) and Heaviness of Smoking Index (HSI) are extensively used methods to measure the severity of nicotine dependence among smokers. The primary objective of the study was to assess the nicotine dependence amongst currently smoking Nepalese population. Methods A community based cross-sectional study was conducted between August and November 2014. Information was collected using semi-structured questionnaire from three districts of Nepal. Data on demographic characteristics, history of tobacco use and level of nicotine dependence were collected from 587 smokers through face to face interviews and self-administered questionnaires. Non-parametric test were used to compare significant differences among different variables. Results The median age of respondents was 28 (Inter-Quartile Range: 22–40) years and the median duration of smoking was 10 (5–15) years. Similarly, the median age for smoking initiation was 16 (13–20) years and the median smoking pack year was 4.2 (1.5–12). One third of the respondents consumed smokeless tobacco products. Half of the respondents wanted to quit smoking. The median score for FTND and HSI was 4 (2–5) and 2 (0–3) respectively. There was significant difference in median FTND score with place of residence (p = 0.03), year of smoking (p = 0.03), age at smoking initiation (p = 0.02), smoking pack year (p < 0.001) and consumption of smokeless products (p < 0.05). Similarly, there was also significant difference in median HSI score with year of smoking (p = 0.002), age of smoking initiation (p < 0.001), smoking pack year (p < 0.001), and consumption of smokeless products (p < 0.05). As per FTND test score, two in ten current smokers had high nicotine dependence (FTND > 6), and HSI scored that three in ten current smokers had high nicotine dependence (HSI > 3). Conclusion Our finding revealed that nicotine dependence is prevalent among Nepalese smoking population. Further studies are required for assurance of tools through bio-markers. Next, smoking cessation program need to be developed considering level of nicotine dependence and pattern of tobacco use.
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Affiliation(s)
- Umesh Raj Aryal
- Department of Community Medicine, Kathmandu Medical College, Sinamangal, Kathmandu Nepal
| | - Dharma Nand Bhatta
- Faculty of Medicine, Epidemiology Unit, Prince of Songkla University, Songkhla, Thailand ; Department of Public Health, Nobel College, Pokhara University, Sinamangal, Kathmandu Nepal
| | - Nirmala Shrestha
- Department of Community Medicine, Kathmandu Medical College, Sinamangal, Kathmandu Nepal
| | - Anju Gautam
- Department of Public Health, Nobel College, Pokhara University, Sinamangal, Kathmandu Nepal
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Panda R, Srivastava S, Persai D, Mathur MR, Modi B, Dave P, Arora M. Preparedness of frontline health workers for tobacco cessation: An exploratory study from two states of India. J Family Med Prim Care 2015; 4:298-304. [PMID: 26288762 PMCID: PMC4535082 DOI: 10.4103/2249-4863.161301] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: The 5As approach is a clinic-based approach and has been developed for primary health care providers who are uniquely positioned to interact with tobacco users. The 5As stands for: Ask about tobacco use at every visit, advise tobacco users to quit, assess readiness to quit, assist quit attempts through counseling and pharmacotherapy and arrange follow-up to prevent relapse. The present study explores whether auxiliary nurse midwives (ANMs) adhere to the 3As from the recommended 5As model for tobacco cessation. Materials and Methods: The study was a cross-sectional study conducted among 501 ANMs in the state of Gujarat and Andhra Pradesh. Descriptive analysis and chi-square test were employed to test the differences in knowledge levels and practices of ANMs. Bivariate logistic regression was used to examine the association between each predictor variable separately and the outcome variables after adjusting for age and location. Data was analyzed using SPSS version 17 software. Results: Majority of ANMs reported that they were aware of respiratory illnesses, tuberculosis, lung and oral cancer as conditions caused due to tobacco consumption. Awareness of adverse reproductive and child health effects associated with tobacco use was very low. Only about one third of respondents informed all patients about harmful effects. Only 16% of ANMs reported having ever received any on-job training related to tobacco control. ANMs who reported receiving training in tobacco control were about two times more likely to provide information on health effects of tobacco as compared to those who reported not being trained in tobacco control in the state of Gujarat. Conclusions: A majority of ANMs ask patients about tobacco use but provide advice only to patients suffering from specific diseases. A context-specific capacity building package needs to be designed to equip ANMs in recommended 5As approach in tobacco cessation.
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Affiliation(s)
- Rajmohan Panda
- Department of Non Communicable Diseases, Public Health Foundation of India, New Delhi, India
| | - Swati Srivastava
- Department of Non Communicable Diseases, Public Health Foundation of India, New Delhi, India
| | - Divya Persai
- Department of Non Communicable Diseases, Public Health Foundation of India, New Delhi, India
| | - Manu Raj Mathur
- Department of Non Communicable Diseases, Public Health Foundation of India, New Delhi, India
| | - Bhavesh Modi
- Department of Preventive and Social Medicine, Government Medical College, Gujarat, India
| | - Paresh Dave
- Department of Health and Family Welfare, Government of Gujarat, Gujarat, India
| | - Monika Arora
- Department of Non Communicable Diseases, Public Health Foundation of India, New Delhi, India
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Persai D, Panda R, Mathur MR. Self-reported Practices and Attitudes of Community Health Workers (Accredited Social Health Activist) in Tobacco Control - Findings from two states in India. Int J Prev Med 2015; 6:48. [PMID: 26124945 PMCID: PMC4462774 DOI: 10.4103/2008-7802.158177] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 04/13/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The 1978 declaration (Alma-Ata declaration) made at the International Conference on Primary Health Care, meeting in Alma-Ata highlighted the critical role played by Community Health Workers (CHWs) to link communities to the health system. The flagship program of Government of India proposed introduction of CHWs namely Accredited Social Health Activist (ASHA). As a link between community and health system ASHA is in a unique position to generate awareness on tobacco-related issues. However, there is limited evidence on practices of ASHAs in tobacco control in India. The present study explores whether CHWs such as ASHAs can be utilized as a resource for informing and educating community on tobacco and its harmful effects. The study captured perceptions and practices of ASHAs regarding tobacco control. METHODS The study was a cross-sectional study conducted among 512 ASHAs in six intervention districts each in Gujarat and Andhra Pradesh. The study settings (i.e., health facilities and villages) were selected through systematic random sampling. The study participants were selected through simple random sampling. Responses were captured through self-administered questionnaire. Logistic regression model was applied to measure associations between variables such as knowledge level of ASHAs and information provided on different tobacco-related diseases by them in both the states, with statistical significance based on the Chi-square test. RESULTS Our findings indicate that ASHAs linked tobacco usage to diseases such as respiratory problems, lung cancer, tuberculosis, and oral disease. Only one-third of ASHAs reported informing all patients about the harmful health effects of tobacco, whereas more than half of them reported providing information only to patients suffering from specific illness. ASHAs who reported having received training in tobacco control were about Two times more likely to give information on effects of tobacco on respiratory diseases (odds ratio [OR]-1.5; confidence interval [CI]: 1.1-2.4) and adverse reproductive outcomes (OR-2.1; CI: 1.1-20.2). CONCLUSIONS Study findings reflect suboptimal engagement of ASHAs in providing information pertaining to specific tobacco-related diseases. There is an urgent need to sensitize and train ASHAs in appropriate tobacco control practices.
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Affiliation(s)
- Divya Persai
- Department of Non-Communicable Diseases, Public Health Foundation of India, New Delhi, India
| | - Rajmohan Panda
- Department of Non-Communicable Diseases, Public Health Foundation of India, New Delhi, India
| | - Manu Raj Mathur
- Department of Non-Communicable Diseases, Public Health Foundation of India, New Delhi, India
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Jayakrishnan R, Mathew A, Uutela A, Auvinen A, Sebastian P. Multiple approaches and participation rate for a community based smoking cessation intervention trial in rural Kerala, India. Asian Pac J Cancer Prev 2015; 14:2891-6. [PMID: 23803049 DOI: 10.7314/apjcp.2013.14.5.2891] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To illustrate multiple approaches and to assess participation rates adopted for a community based smoking cessation intervention programme in rural Kerala. MATERIALS AND METHODS Resident males in the age group 18-60 years who were 'current daily smokers' from 4 randomly allocated community development blocks of rural Thiruvananthapuram district, Kerala (2 intervention and 2 control groups) were selected. Smoking status was assessed through house-to-house survey using trained volunteers. Multiple approaches included awareness on tobacco hazards during baseline survey and distribution of multicolour anti-tobacco leaflets for intervention and control groups. Further, the intervention group received a tobacco cessation booklet and four sessions of counselling which included a one-time group counselling cum medical camp, followed by proactive counselling through face-to-face (FTF) interview and mobile phone. In the second and fourth session, motivational counselling was conducted. RESULTS Among 928 smokers identified, smokers in intervention and control groups numbered 474 (mean age: 44.6 years, SD: 9.66 years) and 454 respectively (44.5 years, SD: 10.30 years). Among the 474 subjects, 75 (16%) had attended the group counselling cum medical camp after completion of baseline survey in the intervention group, Among the remaining subjects (n=399), 88% were contacted through FTF and mobile phone (8.5%). In the second session (4-6 weeks time period), the response rate for individual counselling was 94% (78% through FTF and 16% through mobile phone). At 3 months, 70.4% were contacted by their mobile phone and further, 19.6% through FTF (total 90%) while at 6 months (fourth session), the response rate was 74% and 16.4% for FTF and mobile phone respectively, covering 90.4% of the total subjects. Overall, in the intervention group, 97.4% of subjects were being contacted at least once and individual counselling given. CONCLUSION Proactive community centred intervention programmes using multiple approaches were found to be successful to increase the participation rate for intervention.
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Menon J, Joseph J, Thachil A, Attacheril TV, Banerjee A. Surveillance of Noncommunicable Diseases by Community Health Workers in
Kerala: The Epidemiology of Noncommunicable Diseases in Rural Areas (ENDIRA)
Study. Glob Heart 2014; 9:409-17. [DOI: 10.1016/j.gheart.2014.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 06/29/2014] [Accepted: 07/17/2014] [Indexed: 12/15/2022] Open
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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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Sarkar BK, Arora M, Gupta VK, Reddy KS. Determinants of tobacco cessation behaviour among smokers and smokeless tobacco users in the states of Gujarat and Andhra Pradesh, India. Asian Pac J Cancer Prev 2014; 14:1931-5. [PMID: 23679295 DOI: 10.7314/apjcp.2013.14.3.1931] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was undertaken to identify the socio-demographic determinants of quit attempts among smokers and smokeless tobacco users to identify correlates of tobacco cessation behaviour in India. MATERIALS AND METHODS This was a cross-sectional study for the outcome of quit attempts made by current tobacco users in last 12 months in twelve districts in two states. Simple and multivariable logistic regression analysis was used to obtain the odds ratios (ORs) of socio-demographic variables (age, gender, education, occupation, socio- economic status, community, area, type of family) and tobacco user status (smoker/smokeless). RESULTS In the combined analysis, a smoker had higher predicted probability of attempting quitting (OR- 1.41,CI 1.14 -1.90), in comparison to a smokeless tobacco user and a tobacco user in the state of Gujarat was less likely to attempt quitting than a user in Andhra Pradesh (OR-0.60, CI 0.47-0.78). The probability of making a quit attempt was higher among tobacco users who were more educated (OR-1.40, CI 1.04-1.94), having a higher socio-economic status (SES) (OR-2.39, CI 1.54-3.69), and belonging to non-agricultural labourer occupational group (OR-1.90, CI 1.29-2.78). The effects were maintained even after adjusting for all other variables. In disaggregated analysis, findings were similar except in smokeless as a separate group, education level was not significantly associated with quit attempts and with lower odds (OR-0.91, CI 0.58-1.42). CONCLUSIONS This is one of the first studies to provide useful insight into potential determinants for quit attempts of tobacco users in India including smokeless tobacco users, exploring the socio-demographic patterning of correlates of quit attempts.
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Affiliation(s)
- Bidyut K Sarkar
- Department of Epidemiology and Public Health, University College London, London, UK.
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