|Year : 2021 | Volume
| Issue : 3 | Page : 71-73
Assessment of outcomes of a hospital-based tobacco cessation intervention program: A retrospective study
Nilesh Arjun Torwane1, Ashwini Dayma2, Sudheer Hongal3, Priyanka Anil Ahire4
1 Associate Professor, Department of Public Health Dentistry, Saraswati Dhanwantari Dental College, Parbhani, Maharashtra, India
2 Lecturer, Department of Community and Preventive Dentistry, People's Dental Academy, Bhopal, Madhya Pradesh, India
3 Professor, Department of Public Health Dentistry, HKDET'S Dental College and Hospital, Humnabad, Karnataka, India
4 Assistant professor, Department of Quality Assurance, Bharti Vidyapeet college of Pharmacy, Navi Mumbai, Maharashtra, India
|Date of Submission||19-May-2021|
|Date of Acceptance||04-Jun-2021|
|Date of Web Publication||27-Sep-2021|
Dr. Nilesh Arjun Torwane
Department of Public Health Dentistry, Saraswati Dhanwantari Dental College, Parbhani, Maharashtra
Source of Support: None, Conflict of Interest: None
Background: Tobacco use among adult Indian population is 34.6% by Global adult tobacco survey (2016–2017) reported 6.8 crores urban, 19.9 crores rural Indians are tobacco consumers. M. P state fact file declares highest tobacco consumers residing in Madhya Pradesh.
Methodology: The current study is an individual as well as community-based tobacco intervention program, to evaluate the trends of tobacco use, awareness related to tobacco hazard, quit tobacco regime, withdrawal, relapse in post intervention follow-up.
Results: In the total regime of 3 months starting from detox groundwork of body for cessation to behavior modification, phase of nicotine replacement therapy (NRT) to pharmacological intervention at spaced out follow-up the graph gradually declined down of individuals positively motivated for quitting.
Conclusion: Tobacco cessation (quitting) with behavior modification, NRT, and Pharmacological mode is a relatively novel approach of tobacco control in India. It is considered to be the most cost-effective intervention as compared to other tobacco control programs and other approaches of reducing tobacco menace.
Keywords: Behavior counseling, nicotine dependence, nicotine replacement, tobacco-cessation
|How to cite this article:|
Torwane NA, Dayma A, Hongal S, Ahire PA. Assessment of outcomes of a hospital-based tobacco cessation intervention program: A retrospective study. Int J Prev Clin Dent Res 2021;8:71-3
|How to cite this URL:|
Torwane NA, Dayma A, Hongal S, Ahire PA. Assessment of outcomes of a hospital-based tobacco cessation intervention program: A retrospective study. Int J Prev Clin Dent Res [serial online] 2021 [cited 2023 Mar 28];8:71-3. Available from: https://www.ijpcdr.org/text.asp?2021/8/3/71/326827
| Introduction|| |
Tobacco users in India Global adult tobacco survey (GATS-2) 2016–2017 statistics states urban 6.8 crore, rural 19.9% crores tobacco consumers in India. GATS 2 Madhya Pradesh state fact file states number of smokeless tobacco user are highest in Central India. The women tobacco users contribute to 17.3% which is very high as well as alarming.,,,,,, Out of pocket expenditure on medical care attributed to tobacco has been reported to result in high poverty rates affecting 0.93 million people in India. The total economic cost attributable to tobacco use in India year 2011 for person aged 35–69 amount to Rs 104,500 crores. The cost of immature mortality was highest in the age group of 40–44 years is Rs 20,300 crores. Maintaining a tobacco surveillance system at each tier of health system by training health professionals, scions of literates, school teachers, and skeletal staff of primary health centers and incorporating the sensitization component into adult literacy programs. The assessment of tobacco control measures is a prime step in controlling the menace., The present study provides an insight in tobacco cessation activities as well as the explicit percentage of cessation rate its pattern in a decade of tobacco use, tobacco dependence, and the impact of tobacco cessation regime at an established tobacco cessation center.
| Methodology|| |
The current study is an individual as well as community-based tobacco intervention program. Mainly evaluating the trends of tobacco use, awareness related to tobacco hazard, initiation to quit, contemplation and precontemplation dilemma for quit attempt, relating the quit rate with respect to withdrawl, relapse followed by post intervention follow-up. A 10-year retrospective report on a cohort of tobacco users of smoked and smokeless form in an established tobacco cessation counseling center at a renowned university of Central India. All procedures performed in the study were conducted in accordance with the ethics standards given in 1964 Declaration of Helsinki, as revised in 2013. The study proposal was submitted for approval and clearance was obtained from the ethical committee of our institution. A written informed consent was obtained from each participant. The data collected are analyzed annually to evaluate the quit rate, relapse, and habit status of the individual. Each year the statistics of tobacco pattern use, reduce and curtail was recorded, analyzed, and displayed on the No tobacco day with the measures to control the tobacco menace and sensitize the populations on ill effects of tobacco and quit regime helping individuals to quit with evaluation and re-evaluation of roadblocks with 5 R. The current data are the compilation from May 2007 to May 2017 and analyze cessation and tobacco habit only with behavior modification or with nicotine replacement therapy or pharmacotherapy for cessation.
| Results|| |
[Table 1] illustrates the entire cohort visited the tobacco cessation clinic over the period of 10 years. Smoked tobacco users and smokeless tobacco users were registered separately. Cohort recorded for genuine quit attempt is considered an effective cohort for tobacco cessation therapy. After thorough behavior modification and detoxification of the blood nicotine level, individual is explained the entire process and duration of refrainment. The cumulative assessment shows only 26.7% registered with contemplation of quitting tobacco. Attrition of individuals for positive intention of quitting was much less than the disinterested individuals from the quit program 73.2%.
|Table 1: Year-wise distribution of Cohort of tobacco users with quit registries and impact (quit)|
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| Discussion|| |
A study from Gujarat reported 60.2% encouraged for quitting in the present study 68.2% were motivated initially in a quit campaign which is distinctly high due to specialized core competent effort in a tobacco cessation center with more prominence on health education and behavior modification as it a modest mode of quit regime in terms of cost and changing attitudes for adapting positive lifestyle for healthful living.,,,, GATS 1 reported 34.6% tobacco users reduced to 28.6% by 20-16-17 GATS 2 report our effort of reduction in our quit movement shows a positive impact on national quit rate., Cessation (quitting) is a relatively new area in tobacco control in India. It is considered to be the most cost-effective intervention as compared to other tobacco control program in India. In the developing nation like India, behavior therapy and cessation practice are the most cost-effective and with a lasting effect on setting the mind frame toward tobacco-free nation.,
| Conclusion|| |
On analyzing the retrospective cohort report on tobacco inflictors for pharmacodynamics of tobacco cessation reveals 30.2% was a quit impact resulting over the period of 10 years. Behavior modification is the most effective step in the quit regime at every follow-up quit therapy 68.8% of individuals contemplated quit post behavior therapy 38.8% of individuals benefitted and positively inclined in quit regime plan. Cold turkey mode of quitters was least but consistent and determined most of them belong to drop-in mode the individuals walked in a cessation clinic. Individuals and community intervention having family support the impact.
Tobacco control is inexpensive to implement and impact as quit rate is very encouraging. There should be a constant effort from each and every one required to combat against this dreadful threat which is extremely preventable. The innovative anti-tobacco campaign, lobbying against tobacco, anti-tobacco propaganda, strict legislation, and overall strong political commitment is required for Tobacco-Free India.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
New Delhi: Ministry of Health and Family Welfare, Government of India; 2010. International Institute for Population Sciences (IIPS), Mumbai. Global adult tobacco survey India (GATS India), 2009-2010.
Shafey O, Eriksen M, Ross H, Mackay J. The Tobacco Atlas 3rd
ed. Atlanta, Georgia, USA: American Cancer Society; 2009.
Murthy P, Saddichha S. Tobacco cessation services in India: Recent developments and the need for expansion. Indian J Cancer 2010;47 Suppl 1:69-74.
Kumar MS, Sarma PS, Thankappan KR. Community-based group intervention for tobacco cessation in rural Tamil Nadu, India: A cluster randomized trial. J Subst Abuse Treat 2012;43:53-60.
Pradeep Kumar AS. Smoking cessation intervention program in Primary Health Centres in Palakkad district, Kerala. In: Thiruvananthapuram, Kerela, India: Unpublished PhD thesis, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology; 2009.
Thankappan KR, Pradeepkumar AS, Nichter M. Doctors' behaviour and skills for tobacco cessation in Kerala. Indian J Med Res 2009;129:249-55.
] [Full text]
Mony PK, Rose DP, Sreedaran P, D'Souza G, Srinivasan K. Tobacco cessation outcomes in a cohort of patients attending a chest medicine outpatient clinic in Bangalore city, southern India. Indian J Med Res 2014;139:523-30.
] [Full text]
Thankappan KR, Mini GK, Hariharan M, Sarma PS, Vijayakumar G, Nichter M. Smoking cessation among diabetes patients: One year follow-up results of a randomized controlled trial in Kerala, India. Diabetes 2013;62:A1-98.
Hanioka T, Ojima M, Tanaka H, Naito M, Hamajima N, Matsuse R. Intensive smoking-cessation intervention in the dental setting. J Dent Res 2010;89:66-70.
Carr AB, Ebbert J. Interventions for tobacco cessation in the dental setting. Cochrane Database Syst Rev 2012;2012:CD005084.