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Authors: G Mishra, V Majmudar, S Gupta, P Rane, et al.

Reference: Indian J Occup Environ Med 2009; 13(3): 146-153 (open access)
http://www.ijoem.com/article.asp?issn=0019-5278;year=2009;volume=13;issue=3;spage=146;epage=153;aulast=Mishra

Reviewer: Carlos Mendoza Montano, PhD, ProCor contributing editor; President, Guatemalan Association for the Prevention of Heart Diseases (APRECOR), Guatemala City, Guatemala

Reviewer comments: India is the second largest consumer of tobacco in the world. The available literature on tobacco cessation is mostly from the western countries and hence it was imperative to study it in the Indian context. The program described in this paper gave a unique opportunity to study the prevalence of tobacco use among industrial employees and provide professional help to quit tobacco. The program was innovative in the sense that it changed the atmosphere regarding tobacco consumption on the entire industrial campus, thus exemplifying how peer pressure can bring about a positive change in the life style of an entire group. The program has succeeded in reaching out to the local community with the ‘quit tobacco' message, and provides a model for workplace tobacco cessation and oral cancer screening at industrial settings, which could be useful to promote tobacco control at other workplaces.

Purpose of study: To assess tobacco quit rates among employees; compare post-intervention KAP (knowledge, attitudes and practices) regarding tobacco consumption with the pre-intervention responses and assess tobacco consumption pattern among contract employees and provide assistance to encourage quitting.

Location of study: Maharashtra, India

Study design: This is an interventional cohort study of one year duration among 104 employees working in a chemical industrial unit at rural Maharashtra. All employees were interviewed and screened for oral neoplasia. Active intervention in the form of awareness lectures, focus group discussions and if needed, pharmacotherapy was offered. Medical staff from the industrial medical unit and from a local referral hospital was trained. Awareness programs were arranged for the family members and contract employees. Thereafter, the tobacco users were followed up at an interval of six to eight weeks. The follow-up sessions comprised focus group discussions among tobacco users to elicit information on various issues related to tobacco consumption and quitting.

Results: The initial interview findings indicate tobacco consumption rate of 48% (50 tobacco users), of which seven employees used smoking forms, 33 smokeless forms and 10 used a combination of smoking and smokeless forms. The tobacco quit rates increased with each follow-up intervention session and reached 40% at the end of one year. There was 96% agreement between self report tobacco history and results of rapid urine cotinine test. The post-intervention KAP showed considerable improvement over the pre-intervention KAP. 56% of contract employees used tobacco and 55% among them had oral pre-cancerous lesions.

Additional references:
R Bhonsle, P Murti, P Gupta. Tobacco habits in India. In: P Gupta, J Hamner, P Murty, eds. Control of tobacco-related cancers and other diseases. Proceedings of an International Symposium, 15-19 January 1990. Mumbai: TIFR, Oxford University Press; 1992: 25-46. (open access) http://books.google.com/books?id=-Zqo67BjH7UC&lpg=PP1&ots=xHq2ddk3iQ&dq=Control%20of%20tobacco-related%20cancers%20and%20other%20diseases.%20Proceedings%20of%20an%20International%20Symposium%2C%2015-19%20January%201990&pg=PA25#v=onepage&q&f=false

M Rani, S Bonu, P Jha, S Nguyen, L Jamjoum. Tobacco use in India: Prevalence and predictors of smoking and chewing in a national cross sectional household survey. Tob Control. 2003; 12:e4. http://tobaccocontrol.bmj.com/content/12/4/e4.abstract