pilot study experience from North East India where tobacco use is very rampant

1. Dr. Srabana Misra Bhagabaty: Assistant Professor cum In-Charge,
Department of preventive oncology, Dr. B. Borooah Cancer Institute
Published in : Asian Pacific Journal of Cancer Prevention, Vol. 16, 2015 , page 811-814
Got the certificate of excellence for best paper presentation at the international conference : Global
Cancer Summit, Bangaluru 2015

2. Dr. Srabana M
Bhagabaty

3. with alarmingly High Prevalence of Tobacco Use in the region
and poor health seeking behavior reflecting least utilization of
the clinic based tobacco cessation service this intervention
research design means to
To assess impact when care providers go out to the
community to provide tobacco cessation help in areas with
high tobacco consumption and least motivation towards
quitting or availing cessation clinic help.
Some community based tobacco cessation intervention
studies has been conducted outside India but only few
studies in India.
In North East India this is a first such kind of pilot study to
see the feasibility of implementation of such intervention
designs in the region and other parts of the country
Dr. Srabana M

4. Objectives of this study
Finding out the practicability of providing tobacco
cessation intervention at community level.
To analyze the success of tobacco cessation
services extended to the community level.
Iii Comprehending the prospect of implementation of
Community based tobacco cessation intervention at
large scale and to suggest recommendations for
better tobacco cessation service
Dr. Srabana M
Bhagabaty

5. Methodology
Dr. Srabana M
Bhagabaty

6. • Community based intervention study
• Study sample : 800
• Duration of the study : one year
• Study period: 2009-2010
Dr. Srabana M
Bhagabaty
Methodology…

7. • Study area: Assam : It was carried out in
South, East, West and Central urban blocks
of Guwahati Metro.
• Tool of data collection : Predesigned
pretested proforma
• Data entry and analysis: SPSS
Dr. Srabana M
Methodology…

8. The inclusioncriteria for the study
Tobacco users of both sex, aged >15 years and
permanent residents of study areas willing to
take part in the study.
The exclusion criteria were
Non users of tobacco, past users of tobacco,
tobacco users of age less than 15 years, not willing
to get tobacco cessation intervention, not
permanent residents of the study areas.
Dr. Srabana M
Methodology…

9. Four Medical social workers (MSWs) were
recruited and trained up
They conducted door to door survey in the study
area and registered the study subjects ( 200
study subjects per MSW)
Dr. Srabana M
Methodology…

10. During registration :
Information communication and education
materials on tobacco hazards were offered
to the study subjects
A date and time for counseling was fixed
according to the convenience of the
subjects a keeping in mind time frame of
the study .
Dr. Srabana M
Bhagabaty
Methodology…

11. Dr. Srabana M
Methodology…

12. By :Direct contact
Intervals and duration :
0-2 weeks, 2- 4 weeks, 4-6 weeks, 6weeks-2months,
2-3months, 3-4 months, 4- 6 months, 6-8 months.
When contacted for follow up the study subjects ,
needed re-counseling was given to them where
needed
Dr. Srabana M
Methodology…

13. Dr. Srabana M
Bhagabaty

14. • The survey covered 750 households
• 87% of these households with a nuclear family
• Persons in the age group >15years and permanent
residents of these areas were 2100 out of which 860
were current tobacco users
• 60 of these 860 could not meet the inclusion criteria
Results and discussions….
Dr. Srabana M
Bhagabaty

15. Dr. Srabana M
0%
10%
20%
30%
40%
50%
60%
70%
80%
Age Distribution of the study subjects
15-19
years:
3%
Results and discussions….
20-39
Years
: 78%
40-59
Years:
18%
>60
years:
1%

16. 81%
19%
MALE FEMALE DISTRIBUTION OF THE STUDY SUBJECTS
MALE
FEMALE
Dr. Srabana M
Bhagabaty
Results and discussions….

17. literacy status of the study subjects
Dr. Srabana M
42%
33%
14%
4%
4% 3%
College
Higher secondary
High school
Middle school
primary school
Illiterate
Results ….

18. Monthly income of the subjects
Dr. Srabana M
3%
55.25%
35.88%
5.88%
<Rupees
2000
Rupees
2001-5000
Rupees
5001-10,000
> Rupees
10,000
Results ….

19. • Study population showed current tobacco use
of 36%
• Only 1/4th of the subjects (current tobacco
users) visited any health care provider during
last 12 months
!!!Only 3% of current tobacco users( both
smoking or smokeless type) got any
kind of advice to quit the tobacco use
habit
Dr. Srabana M
Bhagabaty

20. (Manuals for training in cancer control:
Manual for tobacco cessation: national
cancer control programme : Directorate
general of health services: MOHFW: govt. of
India.)
15.00%
15.50%
16.00%
16.50%
17.00%
17.50%
18.00%
Tobacco cessation centers
(TCC)from India, have
reported overall quit rates
of around 16% and study
result was 17.87% at six
weeks post intervention
Study result
TCC results
Dr. Srabana M

21. The final outcome
Results of follow up at eight months post intervention
Outcome Number Percentage
Quit Tobacco 376 47%
Reduced tobacco use (More than
50%)
415 52%
No material change 0 0
Lost to follow up 0 0
Relapse 6 1
Total 800 100
Dr. Srabana M

22. • 100% motivation and 99% changed for better.
47% quitted completely or they were at the verge
of quitting the habit with visible big reduction
(52%) in their tobacco consumption both in
quantity and use times per day
• Lost to follow up was zero and relapse rate was
negligibe
Dr. Srabana M

23. Dr. Srabana MDr. Srabana M
• For a better motivation, follow up
and a better quit rate in a defined
population, the community based
tobacco cessation interventions
could be an answer

24. Recommendation
 Such vigorous intervention designs should be
given more emphasis on for Implementation, in a
specified community with a very high tobacco
consumption rate, cultural acceptance of tobacco
and less motivation towards quitting.
Use pharmaceutical adjuncts along with
counseling at the community settings needs
further research to see impact for a even better
quit rate and feasibility of implementation
Dr. Srabana M

25. Better results towards awareness generation about
tobacco hazards and benefits of quitting.
To address needs of the needy bypassing all the barrier
limiting the mass from seeking
tobacco cessation help.
For attaining high tobacco quit rate and lesser lost to
follow up and close monitoring of maintenance of tobacco
cessation
Dr. Srabana M
Bhagabaty
TO GET

26. >Dr. Amal Chandra Kataki, Director
Dr. B.Borooah Cancer Institute
>Dr. Sekhar Shalkar , National organisation for Tobacco Eradication India, GOA
>Manoj Kalita,Population based Cancer Registry,
Dr. B.Borooah Cancer Institut
Acknowledgement
Dr. Srabana M
Bhagabaty

27. Dr. Srabana M

29. THANK YOU
Dr. Srabana M