Community-based model for preventing tobacco use among disadvantaged adolescents in urban slums of India.

HRIDAY, New Delhi, India.
Health Promotion International (Impact Factor: 1.94). 02/2010; 25(2):143-52. DOI: 10.1093/heapro/daq008
Source: PubMed

ABSTRACT Tobacco consumption in multiple forms presents an emerging, significant and growing threat to the health of Indian adolescents, especially those from low socio-economic communities. Research in two phases was undertaken among economically disadvantaged adolescents in two urban slums of Delhi. In phase I, qualitative research methods such as focus group discussions and in-depth interviews were used to explore and understand the determinants influencing tobacco use among these adolescents. Prevalence of tobacco use was higher among boys than girls. Adolescents reported using tobacco in multiple forms, chewing tobacco being the most popular. Peer pressure, easy availability and affordability were important reasons associated with tobacco initiation and continued use. Though they had some knowledge about the harmful effects of tobacco, this was not sufficient to motivate them to abstain or quit. The community-based intervention model developed on the basis of the results of phase I was evaluated in phase II in a demonstration study with two slum communities. One was treated as the intervention and the other as control. A significant difference in current use of tobacco was observed between the study groups (p = 0.048), with the intervention group showing a reduction in use, compared with an increase in use among the control group. Post-intervention, the intervention group reported significantly lower fresh uptake (0.3%) of tobacco use compared with the control group (1.7%). No significant change was found for quit rate (p = 0.282) in the two groups. Community-based interventions can be effective in preventing adolescents from initiating tobacco use in a low-resource setting such as India.


Available from: Abha Tewari, May 30, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: There is no study on the association between oral health education and oral health quality of life (OHQoL). AIM: To assess the relationship between oral health education activities integrated into primary care services and OHQoL in adolescents. DESIGN: A retrospective observational survey was conducted on 300 randomly selected 12-14 years-of-age adolescents living in two publicly funded health service administrative areas in Manaus, Brazil. Between 2006 and 2008, dental treatment and oral health education were offered in one area (DT/OHE group), whereas in the other area, only dental treatment was provided (DT group). Collected data included socio-demographic characteristics, health services use, health-related behaviours, dental pain, dental caries and Child-OIDP. Independent variables were compared between groups by Mann-Whitney and chi-square tests. The association between one or more OIDP (Child-OIDP ≥ 1) and DT group tested using multivariate logistic regression. RESULTS: Caries, use of dental services and health-related behaviours did not differ between groups (P > 0.05). Child-OIDP ≥ 1 was higher in DT group (90.0%) compared with DT/OHE group (79.3%) (P = 0.01). Child-OIDP ≥ 1 was independently associated with DT group [OR = 4.4 (1.1; 17.0)]. CONCLUSIONS: Adolescents living in an area where OHE and DT were provided had better OHRQoL than those living in an area where only DT was provided.
    International Journal of Paediatric Dentistry 10/2012; DOI:10.1111/ipd.12006 · 1.54 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: ijmedph Vol 4 | Issue 4 | Oct-Dec 2014 SciBiolMed.Org -A non-profit private organization dedicated to Research in the field of Science, Biology and Medicine. It provides high quality, accurate and required information to enhance re-search and innovative concepts in scholarly publishing. Editor : Dr. Subhankar Chakraborty (USA) The journal is indexed with CAB Abstracts, An overview of qualitative research methodology for public health researchers Role of biomedical and behavioral interventions and their evidence in prevention of HIV infection: A literature review Indian public health standards for Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy facilities: An assessment Osteoporotic hip fractures in low-income group population, hospital based case control study from India A study of the drugs used in chronic obstructive pulmonary disease and their impact on quality-of-life more in this issue. Determinants of tobacco use and perception, attitude about an antitobacco act in rural Haryana, North India Background: Tobacco use is one of the most important preventable causes of morbidity and mortality in India. It is essential to study perception, practices and factors determining tobacco use to formulate the intervention for addressing this problem in the community. Materials and Methods: A cross-sectional study was carried out in 28 villages in Ballabgarh block of Faridabad, Haryana. This study aimed to understand factors determining tobacco use and to assess knowledge, attitude, practices about tobacco use and antitobacco act. Systematic random sampling was done to select study subjects. Total calculated sample size was 880. One eligible male and one female were selected randomly from household. Knowledge was assessed using semi-structured interview schedule while attitude using fi ve-point likert scale. In addition, focus group discussions and in-depth interviews were conducted among various stakeholders and opinion leaders to get insight about practices and factors determining tobacco use in the community. Results: Total 892 subjects were enrolled in the study, of which 51% were male. The mean age of the study subjects was 49.5 years (standard deviation: 17.5). Though awareness about harmful effects of tobacco use was reported, awareness about legislations under an antitobacco act was poor. Early initiation and continued use of all forms of tobacco were reported. Prevalent practice of tobacco use was attributed to pressure from peer groups, social customs and lack of de-addiction services at the community level by study subjects. Conclusion: Tobacco use in this rural community was mainly attributed to social and cultural factors. A multi-pronged public health approach is needed for addressing this complex problem the community.
    10/2014; 4(4). DOI:10.4103/2230-8598.144069
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Tobacco control needs in India are large and complex. Evaluation of outcomes to date has been limited. To review the extent of tobacco control measures, and the outcomes of associated trialled interventions, in India. Information was identified via database searches, journal hand-searches, reference and citation searching, and contact with experts. Studies of any population resident in India were included. Studies where outcomes were not yet available, not directly related to tobacco use, or not specific to India, were excluded. Pre-tested proformas were used for data extraction and quality assessment. Studies with reliability concerns were excluded from some aspects of analysis. The Framework Convention on Tobacco Control (FCTC) was use as a framework for synthesis. Heterogeneity limited meta-analysis options. Synthesis was therefore predominantly narrative. Additional to the Global Tobacco Surveillance System data, 80 studies were identified, 45 without reliability concerns. Most related to education (FCTC Article 12) and tobacco-use cessation (Article 14). They indicated widespread understanding of tobacco-related harm, but less knowledge about specific consequences of use. Healthcare professionals reported low confidence in cessation assistance, in keeping with low levels of training. Training for schoolteachers also appeared suboptimal. Educational and cessation assistance interventions demonstrated positive impact on tobacco use. Studies relating to smoke-free policies (Article 8), tobacco advertisements and availability (Articles 13 and 16) indicated increasingly widespread smoke-free policies, but persistence of high levels of SHS exposure, tobacco promotions and availability-including to minors. Data relating to taxation/pricing and packaging (Articles 6 and 11) were limited. We did not identify any studies of product regulation, alternative employment strategies, or illicit trade (Articles 9, 10, 15 and 17). Tobacco-use outcomes could be improved by school/community-based and adult education interventions, and cessation assistance, facilitated by training for health professionals and schoolteachers. Additional tobacco control measures should be assessed.
    PLoS ONE 04/2015; 10(4):e0122610. DOI:10.1371/journal.pone.0122610 · 3.53 Impact Factor