Community Based Group Intervention for Tobacco Cessation in Rural Tamil Nadu
Objective: To determine the efficacy of community based group intervention for tobacco cessation and to identify the barriers for cessation intervention among rural men.
Methods: We recruited 400 men (20-40 years) currently using any form of tobacco from 20 villages of the Indian State of Tamil Nadu and randomized them equally into intervention and control groups. A physician offered two sessions of health education five weeks apart along with self-help material on tobacco cessation to the intervention group. The control group received only self-help material. The contents of the sessions included tobacco related health problems, benefits of quitting and coping strategies for withdrawal symptoms. The outcome measures at two months follow-up were self-reported point prevalence abstinence, quit attempts lasting > 24 hours and harm reduction of tobacco use > 50% of baseline. Follow-up data were available for 92%.
Findings: In the intention to treat analysis, self reported point prevalence abstinence of 12.5% in the intervention group was significantly higher than the 6.0% in the control group [Odds Ratio (OR) 2.39; 95% confidence interval 1.09-5.22]. Harm reduction was three times (OR 2.63, 95% CI 1.36-5.08) and quit attempts were two times (OR 1.66, 95% CI 0.97-2.84) higher in the intervention group than the control group. Time constraints, alcohol consumption and urban migration were found to be important barriers for group based tobacco cessation intervention.
Conclusion: Community based group intervention has the potential to increase the coverage of tobacco cessation services for men in rural Tamil Nadu.
(Clinical Trial Registration Number CTRI/2010/091/000221)
Tobacco has been projected to cause one billion preventable deaths in the twenty-first century, of which more than 70% will