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Call Centre Employees and Tobacco Dependence – Making a Difference
Abstract
India is known as the Business Process Outsourcing (BPO) capital of the world. Safeguarding health of millions of youngsters employed in this new growing economy is an occupational health challenge.
This study was initiated in June 2007 in India with the objectives to assess the prevalence of tobacco use and study the factors responsible for initiating and continuing its use. The main aim, however, was to assess the effect of different tobacco cessation intervention strategies, thus identifying effective methods to assist these employees to quit tobacco.
This is a 4-arm cluster randomized trial of 18 months duration among 646 BPO employees, working in 4 different BPO units. The employees were invited to participate in interviews following which tobacco users of each BPO were offered specific tobacco cessation interventions to assist them to quit tobacco use.
The prevalence of tobacco dependence is 41%, mainly cigarette smoking. The tobacco quit rate is similar (nearly 20%) in the 3 intervention arms. Significantly higher reduction in tobacco consumption of 45% is seen in Arm 4 with the use of pharmacotherapy. BPO employees change jobs frequently, hence follow-up remains a major challenge.
Inaccessibility of pharmacotherapy in the developing countries should not deter tobacco cessation efforts as good tobacco quit rates can be achieved with health education and behavioral therapy. Tobacco cessation should be an integral activity in all BPOs, so that the employees receive this service continuously and millions of our youths are protected from the hazards of tobacco.
... The call center job alters the lifestyle of the women employees considerably. The work embraces nightwork, smoking, drinking, and pub culture, etc. which are in opposition to the values, traditions, and beliefs of the Indian urban middle class (Mishra et al., 2010). Call centers, unlike other industries, provide openings for employment opportunities at a young age, high disposable income, and quick promotion avenues at low educational qualifications. ...
... With high disposable incomes at a young age, the employees fall easy prey to habits such as smoking, drinking alcohol, and interestingly most consider these habits as a style statement (Arora & Kaul, 2005;. Tobacco use among women varied from smoking cigarettes, hookah, and chewing tobacco (Mishra et al., 2010). Though substance use is prevalent among both men as well as women, it is lower among the latter (Mishra et al., 2010;Vaid, 2009). ...
... Tobacco use among women varied from smoking cigarettes, hookah, and chewing tobacco (Mishra et al., 2010). Though substance use is prevalent among both men as well as women, it is lower among the latter (Mishra et al., 2010;Vaid, 2009). Substance use among the call center employees was highlighted by a study conducted in Gurgaon. ...
Indian women are fast moving from conventional jobs to night-shift jobs in transnational call centers. Women working at night is a relatively new phenomenon and stands apart from the usual Indian lifestyle. Night work and the dual burden of work and family have adverse implications on women employees’ physical and psychological health. The paper highlights the occupational health hazards of women employees of international call centers through a systematic review of 38 articles published between 2000 and 2018. Data and evidence from studies on women employees of international call centers in India reveal that odd working hours against the biological clock make women employees suffer from several health problems. Women were more prone to health problems as compared to their counterparts. The responsibility of balancing work and family leads to high levels of stress. Despite the attractive salary package, most women employees suffer health hazards and psychological disorders.
... [15] In the present study, participants' knowledge improved after health awareness program. Similar findings are also noted in other studies, [16,17] suggesting that a well-conducted health awareness program can increase knowledge and assist in quitting the habit. ...
... Tobacco quit rate of 40% was noted in a chemical industry in India, [21] while varying results were obtained with different tobacco cessation interventions in a study among call center employees. [16] In a community-based tobacco cessation program among women in Mumbai, a quit rate of 33.5% was achieved. [9] In the US, as of 2015, 59.1% of adults who had ever smoked had quit. ...
... [9] Female gender was the most important predictive factor for quitting tobacco among the BPO employees. [16] In the present study, 28% of the 400 cab drivers examined had oral precancerous lesions and one cab driver was diagnosed with invasive oral carcinoma. In the Bengaluru study [7] and study conducted in rural India for industrial employees, [22] the number of precancers diagnosed was comparatively lesser than the present study. ...
Background:
Tobacco epidemic is one of the biggest public health threats, killing nearly seven million people annually. With implementation of smoke-free public places legislation, cabs in India are smoke free. However, large majority of cab drivers are addicted to tobacco.
Aims:
The objectives were to measure cab drivers' knowledge, attitude, and practices about tobacco pre and post intervention, educate them regarding hazards of tobacco and need for smoke-free cabs, perform oral cancer screening, and provide assistance to quit tobacco.
Subjects and methods:
This interventional study among cab drivers was conducted in Mumbai during 2015-2018. Different cab unions in Mumbai were contacted and 400 cab drivers were enrolled and interviewed. They were offered health education, oral cancer screening, and tobacco cessation assistance at regular intervals for 1 year.
Results:
About 63.8% of cab drivers used tobacco, mainly in smokeless forms. Almost 94.1% intended to quit, 66.3% had made previous quit attempts, and 69.8% expressed the need of assistance for quitting. One hundred and twelve cab drivers were diagnosed with oral precancers and one with oral carcinoma. About 49.4% of cab drivers quit tobacco and 46.7% reduced tobacco consumption at the end of 1 year. According to multivariate logistic regression analysis, Muslim cab drivers were less likely to quit tobacco as compared to Hindus.
Conclusion:
Adherence to smoke-free laws plays a significant role in reducing exposure of cab drivers to secondhand smoke. This program demonstrates the successful implementation of tobacco cessation program that could be replicated among other workforces.
... [7] A telephonic survey of 646 BPO industry employees revealed 415 were current tobacco users and prevalence of 49.5% in the male employees. 10% of the smokers and 16 % of the smokeless tobacco users had Fagerstrom scores more than 5. [8] A few studies have been done in various categories of industrial workers in India with varying prevalence rates. M Parashar et al reported prevalence of smokeless tobacco user of 49%, smokers 22% and dual users 22% in a study in a sample of 172 male construction workers in Delhi. ...
... [7] A telephonic survey of 646 BPO industry employees revealed 415 were current tobacco users and prevalence of 49.5% in the male employees. 10% of the smokers and 16 % of the smokeless tobacco users had Fagerstrom scores more than 5. [8] It was felt that a survey of larger sample of Industrial workers is required to estimate the burden of tobacco use in industrial workers of this country. ...
... Our figure of workers using exclusively smokeless tobacco and with FTND score above 5 was similar to those found in the study of BPO employees in Mumbai. [8] The mean FTND scores in our sample were lesser than the available research data in Indian populations. The reasons could be that the other studies were done on a sample of selected industrial populations or in a rural population in kerala and hence may not be comparable to our sample. ...
Background: Tobacco use is an important preventable health risk factor in India. Aim: This study was carried out to estimate the prevalence of current tobacco use, factors and extent of dependence associated with its use among male workers of an industrial organization. Materials and Methods: A total of 759 participants randomly selected from the population of employees were administered questionnaire in Hindi containing demographic profile, patterns of smoking, and use of smokeless tobacco and alcohol. Results: Forty-one percent of the surveyed males (n = 750) used tobacco either by smoking or smokeless method or both (9.7% used both, 23.4% smoked, and 27.3% used smokeless tobacco). The maximum percentage was among the 26-30 years' age group, and the married persons (45.4%, OR = 2.17, P < 0.05). Tobacco use was associated with lower educational qualifications, history of tobacco use in family members, and drinking alcohol. Seventy-two percent of the nicotine users reported being influenced by their peers in initiating the habit, 59.4% of the users reported being advised to stop tobacco use by a health professional, and 52.9% had attempted quitting the habit more than once. Twenty percent of our sample were dependent on nicotine and the highest prevalence was seen in those using both smoking and the smokeless tobacco. Conclusions: The Prevalence of Tobacco Use and Nicotine Dependence among male industrial employees is significant and necessitates Tobacco awareness and cessation programs regarding Tobacco use.
... These interventions were multicomponent; including behavioral counseling and Nicotine Replacement Therapy. Quit rates at the end of the intervention were higher compared with other settings, likewise reduction in the use of tobacco were observed (Mishra et al., 2009(Mishra et al., , 2010Pimple et al., 2012;Ransing et al., 2016). These interventions suggested that the workplace, as a setting, provided easier access to employees where they could be monitored on multiple occasions (Pimple et al., 2012) and positive peer pressure among colleagues enabled participants to quit the use of tobacco (Mishra et al., 2009). ...
... These findings were consistent with the broader literature highlighting that the workplace setting provided access to many individuals at the same time (Cahill & Lancaster, 2014;Pimple et al., 2012), positive peer pressure from colleagues motivated one to quit the use of tobacco (Cahill & Lancaster, 2014;Mishra et al., 2009;Ransing et al., 2016;Van den Brand et al., 2018), engagement from the workplace management ensured smooth implementation of the intervention (Mishra et al., 2009), cost for implementation of the intervention acted as a barrier (Kava et al., 2018), high attrition rates impacted the cessation followups (Mishra et al., 2010) and tobacco cessation follow-ups played a critical role in enabling individuals to quit (Pimple et al., 2012). ...
... Our findings diverged from the literature in which smaller workplaces had fewer anti-tobacco policies (Kava et al., 2018), workplaces built alternative healthy lifestyles as an extension to tobacco cessation services (Mishra et al., 2010) and that integrating the intervention into the occupational health and safety department of the workplace was challenging (Sorenson et al., 2017). ...
Background
Tobacco use is projected to cause more than 8 million deaths annually worldwide by 2030 and is currently linked to 1 million annual deaths in India. Very few workplaces provide tobacco cessation as a part of occupational health in India. In this study, we examined promoters and barriers to implementing an evidence-based tobacco cessation program in a workplace setting in India.
Methods
In-depth interviews were conducted with all facilitators (two program coordinators and four counselors) of a workplace tobacco cessation intervention covering implementation efforts in five organizations, including three manufacturing units and two corporate settings.
Findings
The identified promoters for implementation of the program were as follows: (a) workplaces that provided access to many individuals, (b) high prevalence of tobacco use that made the intervention relevant, (c) core components (awareness sessions, face-to-face counseling and 6-months follow-up) that were adaptable, (d) engagement of the management in planning and execution of the intervention, (e) employees’ support to each other to quit tobacco, (f) training the medical unit within the workplace to provide limited advice, and (g) efforts to advocate tobacco-free policies within the setting. Barriers centered around (a) lack of ownership from the workplace management, (b) schedules of counselors not matching with employees, (c) nonavailability of employees because of workload, and (d) lack of privacy for counseling.
Conclusion/Implications for Practice
This study provided practical insights into the aspects of planning, engaging, executing and the process of implementation of a tobacco cessation intervention in a workplace setting. It provided guidance for an intervention within occupational health units in similar settings.
... (13) Mishra ve arkadaşlarının 2010 yılında Hindistan'da bir telefon santralinde çalışan düşük gelir grubundaki işçilerde yaptıkları sigara bırakma konusunda 4 farklı yöntemle destek verdikleri grupta en az %20 oranında sigarayı bırakma gerçekleşmiş, bunun 16-24 ay devam ettiği görülmüştür. (14) İş yerlerinin, sigara bıraktırma konusunda mücadele vermek ve başarı elde etmek için uygun ortamlar olduğu görülmektedir. ...
... Büyük bir kısmı 10-20 yıl arasında kümeleniyordu. Günlük sigara sayısı ağırlıklı olarak(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) adet arasında kümeleniyordu (Tablo 4).Fagerstrom Sigara Bağımlılık Anketine göre 5 ve daha az puan alanların (az bağımlı olanların) sayısı 46 iken, 5-8 puan alanlar 34, 8 den yüksek puan alanlar 57 kişi idi. Halen sigara içmeyen 155 kişiden 29 tanesi bir dönem sigara içip bırakmıştı. ...
... Our figure of workers using exclusively smokeless tobacco and with FTND score above 5 was similar to those found in the study of BPO employees in Mumbai. [8] The mean FTND scores in our sample were lesser than the available research data in Indian populations. The reasons could be that the other studies were done on a sample of selected industrial populations or in a rural population in kerala and hence may not be comparable to our sample. ...
... The reasons could be that the other studies were done on a sample of selected industrial populations or in a rural population in kerala and hence may not be comparable to our sample. [5,8,13] ...
Background
Tobacco use is an important preventable health risk factor in India.
Aim
This study was carried out to estimate the prevalence of current tobacco use, factors and extent of dependence associated with its use among male workers of an industrial organization.
Materials and Methods
A total of 759 participants randomly selected from the population of employees were administered questionnaire in Hindi containing demographic profile, patterns of smoking, and use of smokeless tobacco and alcohol.
Results
Forty-one percent of the surveyed males (n = 750) used tobacco either by smoking or smokeless method or both (9.7% used both, 23.4% smoked, and 27.3% used smokeless tobacco). The maximum percentage was among the 26–30 years’ age group, and the married persons (45.4%, OR = 2.17, P < 0.05). Tobacco use was associated with lower educational qualifications, history of tobacco use in family members, and drinking alcohol. Seventy-two percent of the nicotine users reported being influenced by their peers in initiating the habit, 59.4% of the users reported being advised to stop tobacco use by a health professional, and 52.9% had attempted quitting the habit more than once. Twenty percent of our sample were dependent on nicotine and the highest prevalence was seen in those using both smoking and the smokeless tobacco.
Conclusions
The Prevalence of Tobacco Use and Nicotine Dependence among male industrial employees is significant and necessitates Tobacco awareness and cessation programs regarding Tobacco use.
... This may be due to varied clinical characteristics among patients at baseline with regard to severity of nicotine dependence and stages of motivation. Mishra et al32 also had noticed no significant differences in quit rates between those receiving pharmacologic and non-pharmacologic treatments in a campus intervention in Mumbai, western India32. ...
... This may be due to varied clinical characteristics among patients at baseline with regard to severity of nicotine dependence and stages of motivation. Mishra et al32 also had noticed no significant differences in quit rates between those receiving pharmacologic and non-pharmacologic treatments in a campus intervention in Mumbai, western India32. ...
Background & objectives:
Nicotine dependence is a widely prevalent and harmful chronic addictive disorder. Quitting tobacco use is however, uncommon in India. We present long-term treatment outcomes of out-patient, tobacco cessation treatments from a specialty clinic setting in southern India.
Methods:
Patients seen in a tobacco cessation clinic were characterized for tobacco use, nicotine dependence and motivation for quitting and offered pharmacologic/non-pharmacologic treatment. They were subsequently contacted telephonically at a mean (±standard deviation) of 24 (±9.1) months to assess tobacco cessation outcome defined as ‘point prevalence of 1-month abstinence’ by self-reporting.
Results:
The mean age of participants was 48.0 ±14.0 yr. Tobacco use distribution was: beedis only (22%), cigarettes only (49%), beedis and cigarettes (18%), chewing only (2%), and smoking and chewing (9%). Two-thirds had high level of nicotine dependence. Of the 189 patients enrolled, only 15 per cent attended follow up clinics. Only 106 (56%) patients were successfully contacted telephonically and 83 (44%) were lost to follow up. Self-reported point prevalence abstinence was 5 per cent by ‘intent-to-treat’ analysis and 10 per cent by ‘responder’ analysis. Two clinical parameters – high level of nicotine dependence [estimated by the heaviness of smoking index (HSI)] and the absence of vascular or other chronic disease were found to be associated with successful quitting; these were however, not significant on multivariate analysis.
Interpretation & conclusions:
Our study has identified low quit-rates in a cohort of patients attending a hospital-based tobacco cessation clinic. In the absence of clear-cut predictors of cessation with low quit-rates, there should be continued efforts to improve cessation outcomes and identify predictors for action.
... Mishra GA et al. [14] in 2010 studied call center employees and tobacco dependence and found the prevalence of tobacco dependence was 41% (mainly cigarette smoking). ...
A BSTRACT
Introduction
Like general health, oral health also depends upon their occupational environment and occupational health policies. Workplace exposure to environmental tobacco smoke and its harmful effect is well known. The consumption of tobacco, arecanut, and alcohol is the leading preventable cause for development of oral potentially malignant disorders.
Aim
To determine prevalence of habit-induced oral lesions in different occupations in different geographical places of West Bengal and compare among them.
Method
A total of 841 people aged 15 years and above were selected from different parts of West Bengal. Face-to-face interview was conducted using a structured questionnaire, and oral cavity examination was done in daylight. Data were summarized, and statistical analysis was done.
Statistical Analysis Used
Chi-square test and univariate logistic regression done.
Results
The people in armed forces had cancer-causing habits most, and managers had cancer-causing habits least. People in armed forces had cancer-causing habits most, and people with Group-1 occupation/managers had cancer-causing habits least.
... Of these, 35 were RCTs, and one quasi-experimental study was embedded within a cluster RCT. 32 Ten studies each were conducted in China 30,33-41 and India, [42][43][44][45][46][47][48][49][50][51] four in Turkey, 52-55 three in Malaysia, [56][57][58] two each in Brazil, 59,60 and Pakistan 61,62 and one each in Argentina/ Uruguay, 31 Iran, 63 South Africa, 64 Thailand, 65 and Vietnam. 32 A total of 32 283 adult and 424 adolescent participants were included in this review. ...
Introduction
An estimated 78% of the total deaths attributable to smoking tobacco use occurred in low- and middle-income countries (LMICs) in 2019. In addition, smokeless tobacco increases the risk of all-cause mortality, all cancers, including upper aero-digestive tract cancer, stomach cancer, ischemic heart disease and stroke, with 88% of the mortality burden being borne by the South-East Asian region. Evidence-based interventions from high-income countries (HICs) are not easily transferable to LMICs, as patterns of tobacco use, health beliefs associated with tobacco use, and awareness of specific health risks vary substantially.
Methods
We synthesized the effectiveness of behavioral interventions for tobacco cessation in LMICs through a systematic review and meta-analysis. Interventional studies which delivered individual behavioral intervention and assessed abstinence from tobacco use were included. We examined the pooled intervention effect at 6 months postintervention follow-up.
Results
For continuous abstinence at 6 months, the intervention was superior to the active comparator (RR 2.32; 95% CI 1.78 to 3.02) and usual care (RR 4.39; 95% CI 2.38 to 8.11). For point prevalence abstinence at six months, the intervention was superior to the active comparator (RR 1.76; 95% CI 1.28 to 2.44), and usual care (RR 2.37; 95% CI 1.47 to 3.81). The statistical heterogeneity was substantial to considerable for all comparisons. Only six studies had an overall low risk of bias. Publication bias was observed for all comparisons except for 6-month continuous outcomes.
Conclusions
Implementation research is needed to understand factors for programme sustainability and equity of the impact of behavioral interventions in reducing tobacco use in LMICs.
Implications
Our review is an important step towards understanding the effectiveness of behavior interventions for tobacco cessation suited for LMICs and which are responsive to the contextual needs of such countries.
... ibly high work targets, loss of identity, coupled with high disposable income at a young age may predispose the BPO employees to different forms of dependence, including tobacco[6,7]. ...
Introduction: Business Process Outsourcing (BPO) industry has been rapidly expanding in India over the last 10 years. While em
... These result in negative health outcomes like depression and anxiety (Boo & Oh, 2019;Oh et al., 2017;Yang et al., 2019). These risk factors may increase the level of tobacco dependence (Mishra et al., 2010). ...
Aim:
This study aims to describe smoking related characteristics among female call centre employees in South Korea and identify the factors influencing intention to quit smoking in the next 6 months.
Design:
This is a cross-sectional study.
Methods:
An anonymous online survey was conducted at three call centres of credit card companies in South Korea. Female employees with at least 6 months of experience (n = 115) who were currently smoking were included in this study.
Results:
Overall, 20% of participants intended to quit within 6 months. Female call centre employees find it most difficult to resist the urge to smoke in negative mood situations. Factors affecting the quit intention were higher educational status, previous quit attempts lower perceived risk of craving and higher social support.
Public contribution:
Measuring and monitoring craving as perceived risk and providing social support can be useful for designing smoking cessation interventions in this population.
... [7] In a study conducted among businesses process outsourcing workers, almost half of them used tobacco. [8] There were no studies conducted to assess the prevalence of tobacco consumption or oral mucosal conditions among power station employees in India. Hence, the present study aimed to assess the prevalence and pattern of tobacco usage among workers in the thermal power station. ...
Introduction:
Health of individuals and community. Occupation, being a significant determinant of health, plays a vital role in the outcome of health. Mining being an occupation has it's own characteristics and occupational hazards. One such factor, being tobacco consumption has been sparsely reported among thermal power station workers.
Aims and objectives:
To assess the prevalence of tobacco consumption among thermal power station workers in south India.
Materials and methods:
Simple random sampling was used to collect data from the study in the subjects working in thermal power station. Pretested questionnaire was used to collect demographic and prevalence data pertaining to tobacco consumption. Descriptive statistical analysis was done for the data to express the same in frequencies.
Results:
Among the 401 study subjects, 121 of them consumed tobacco. Among them 59%(n=72) of them used smoking form of tobacco and about 23%(n=28) of them used smokeless form of tobacco. Vast majority73%(n=52) of the smokers used cigarette and 14%(n=19) used bidi.
Conclusion:
A significant number of workers in thermal power station were found to use tobacco. Further studies are required to be conducted on a larger scale followed by analytical studies to establish the strength of association between the occupation related variables and tobacco consumption.
... Outreach initiatives are also distributed through telephone counseling, dedicated quitlines, and mobile and web-based programs [55]. ...
Nicotine in tobacco increases dopamine release, which boosts mood and provides a sense of stress release. However, tobacco's availability in numerous forms for consumption makes it difficult to control addiction-even after programs promoting the awareness of its harm to people, society, and the economy. The influence of family and friends is considered a common reason for starting a nicotine habit. Thus, even though tobacco addiction is a global problem, it is challenging to tobacco's notable economic advantages with public health concerns. The following research provides a comprehensive overview of tobacco addiction, including its history, the current situation, its impact on society and the economy, international guidelines, in-clinic, public health smoking cessation regimes and programs, and government legislation to reduce tobacco use in the general population.
... ibly high work targets, loss of identity, coupled with high disposable income at a young age may predispose the BPO employees to different forms of dependence, including tobacco[6,7]. ...
... (Turner, McNeill, Coleman, Bee, & Agboola, 2013) Researches show that employees are under stress and are prone to addictions. (Mishra, Majmudar, Gupta, Rane, Hardikar, & Shastri, 2010;Mohanty & Madhumita 2014). Addictions are seen to develop in such a population as there are high disposable incomes at a very young age, and smoking is looked at by many as a quick-fix solution to their stress problems. ...
Addiction is of varied types and over the years the focus has not only been on the growing issues of addiction but also on how to prevent relapse on recovering clients. According to Buddhist teaching craving is the cause of suffering and suffering festers itself due to attachment. Once an individual is enlightened he will be able to find a path that ceases such suffering. Mindfulness helps bring about such enlightenment through being conscious and reflective of every moment’s experience. Mindfulness does not stop at being aware alone but extends its teaching to accepting such experiences as they are and letting go. Relapse prevention has long been researched on and new therapies developed to facilitate the same. This conceptual paper looks at how Mindfulness-based relapse prevention therapy works to prevent relapses. The paper focuses on understanding each of the eight-week therapy process and how it progresses in changing thoughts and reducing stress. The paper shows how Mindfulness-based relapse prevention helps clients understand their craving and how to change thoughts in order to deal with a craving thus preventing relapse.
... Further research is needed to expand knowledge factors related to initiation, continuation, and quitting in various population subgroups, including professional groups not included in this study, such as women in the information technology and Business Process Outsourcing (BPO) industry, doctors and other professional groups, as well as less educated women or those from lower socioeconomic groups. Some of the regional studies have suggested that these groups (both genders) are likely to have higher rates of smoking (Garg et al. 2012;Mishra et al. 2010). Finally, the sample size of the study was small but included women from a wide range of ages, educational, social and professional backgrounds, which make the results applicable to a wider population, although the sample was over-represented with middle and higher middle socioeconomic groups, whose beliefs and perceptions may not be generalizable to a wider group of women. ...
Background
In India, the prevalence of smoking among women is increasing, and the reasons behind this are unclear. We aimed to study the factors leading to initiation and maintenance of the smoking habit in women in Pune, India.
Methods
Twenty-seven urban women smokers, ranging from 21 to 60 years of age (31.96 ± 10.70 years), were interviewed between September 2015 and February 2016. The in-depth interviews consisted of questions on pre-decided categories, including initiation, motivation to continue smoking, and risk perception. They were asked to describe their first smoking experience, factors that trigger them to smoke and the benefits that they seek from smoking.
Results
Thematic analysis revealed that peer pressure, curiosity, fascination, experimentation, and belonging to a group were factors that led to initiation, while lack of alternatives for stress relief, work environments, and lack of leisure time activities provided circumstances to continue smoking. Participants recognized a sense of liberation and independence from smoking cigarettes and perceived health risks as minor and distant.
Conclusions
Social factors, apart from peer influence, were important for initiation of
smoking among this study's participants, while individual or personal factors,
such as stress and habit, determined motivation to continue. Low awareness
of health risks, perceived emotional benefits and misconceptions of being in
control of the habit led to further addiction. These factors should be kept in
mind when designing smoking prevention and cessation interventions.
... Further research is needed to expand knowledge factors related to initiation, continuation, and quitting in various population subgroups, including professional groups not included in this study, such as women in the information technology and Business Process Outsourcing (BPO) industry, doctors and other professional groups, as well as less educated women or those from lower socioeconomic groups. Some of the regional studies have suggested that these groups (both genders) are likely to have higher rates of smoking (Garg et al. 2012;Mishra et al. 2010). Finally, the sample size of the study was small but included women from a wide range of ages, educational, social and professional backgrounds, which make the results applicable to a wider population, although the sample was over-represented with middle and higher middle socioeconomic groups, whose beliefs and perceptions may not be generalizable to a wider group of women. ...
In India, the prevalence of smoking among women is increasing, and the reasons behind this are unclear. We aimed to study the factors leading to initiation and maintenance of the smoking habit in women in Pune, India. Twenty-seven urban women-smokers, ranging from 21 to 60 years of age (31.96 ± 10.70 years), were interviewed from September 2015 to February 2016. The in-depth interviews consisted of questions on pre-decided categories, viz., initiation, motivation to continue smoking, and risk perception. Thematic analysis revealed that peer pressure, curiosity, fascination, experimentation and belonging to a group were factors that led to initiation, while lack of alternatives for stress relief, work environments and lack of leisure time activities provided circumstances to continue smoking. Participants recognized a sense of liberation and independence from smoking cigarettes and perceived health risks as minor and distant. These findings can be used to develop or modify interventions to prevent and control smoking among urban Indian women.
... Others have used oral cancer screening for individual workers to promote cessation. [30][31][32][33] This manuscript contributes to this emerging literature on the potential efficacy of workplace interventions designed to improve behaviours associated with NCD risk, such as tobacco control. Building on the existing OSH infrastructure provided a potentially sustainable approach for engaging companies in tobacco control efforts. ...
Objectives We assessed a worksite intervention designed to promote tobacco control among workers in the manufacturing sector in Greater Mumbai, India.
Methods We used a cluster-randomised design to test an integrated health promotion/health protection intervention, the Healthy, Safe, and Tobacco-free Worksites programme. Between July 2012 and July 2013, we recruited 20 worksites on a rolling basis and randomly assigned them to intervention or delayed-intervention control conditions. The follow-up survey was conducted between December 2013 and November 2014.
Results The difference in 30-day quit rates between intervention and control conditions was statistically significant for production workers (OR=2.25, p=0.03), although not for the overall sample (OR=1.70; p=0.12). The intervention resulted in a doubling of the 6-month cessation rates among workers in the intervention worksites compared to those in the control, for production workers (OR=2.29; p=0.07) and for the overall sample (OR=1.81; p=0.13), but the difference did not reach statistical significance.
Conclusions These findings demonstrate the potential impact of a tobacco control intervention that combined tobacco control and health protection programming within Indian manufacturing worksites.
Trial registration number NCT01841879.
... In LMIC, there is limited evidence from uncontrolled, intervention studies to suggest that programs to stop smoking in the workplace are effective in India (Mishra et al., 2010;Pimple, Pednekar, Mazumdar, Goswami, & Shastri, 2012). One controlled study from India reported significant reduction in tobacco consumption in the multicomponent, multilevel, and multimethod intervention group compared with no change in the control group (Prabhakaran et al., 2009). ...
Objective
To reduce risk factors in workplace settings in low- and middle-income countries.Design and SampleWorkplace interventions were utilized as part of the Community Interventions for Health program, a nonrandomized, controlled study undertaken in three communities in China, India, and Mexico. Exactly, 45 industrial, 82 health and 101 school workplace settings with a target population of 15,726. Two independent cross-sectional surveys of workers were conducted at baseline and follow-up, after 18–24 months of intervention activities.MeasuresCulturally appropriate interventions to reduce tobacco use, increase physical activity, and improve dietary intake were delivered in the intervention areas.ResultsExactly, 12,136 adults completed surveys at baseline, and 9,786 at follow-up. In the intervention group, the prevalence of tobacco use reduced significantly in men (−6.0%, p < .001) and the proportion eating five portions of fruit and vegetables daily increased (+6.9%, p < .001) compared with the control group. There were no significant differences between the groups for changes in physical activity or prevalence of overweight.Conclusions
Workplace interventions improved risk factors in China, India, and Mexico.
... Several cessation activities have been conducted at a variety of workplaces in both urban and rural India, demonstrating a good quit rate. [25,26] This method needs to be explored further. ...
This is a review paper comprehensively encompassing the different aspects of tobacco control with particular reference to the Indian scenario. The information on prevalent tobacco habits in India, health hazards and environmental hazards due to tobacco use, passive smoking and its impact, economics of tobacco, legislation to control tobacco in India, the tobacco cessation services and the way ahead for effective tobacco control are discussed. Tobacco is a leading preventable cause of death, killing nearly six million people worldwide each year. Reversing this entirely preventable manmade epidemic should be our top priority. This global tobacco epidemic kills more people than tuberculosis, HIV/AIDS and malaria combined. This epidemic can be resolved by becoming aware of the devastating effects of tobacco, learning about the proven effective tobacco control measures, national programmes and legislation prevailing in the home country and then engaging completely to halt the epidemic to move toward a tobacco-free world. India is the second largest consumer of tobacco globally, and accounts for approximately one-sixth of the world's tobacco-related deaths. The tobacco problem in India is peculiar, with consumption of variety of smokeless and smoking forms. Understanding the tobacco problem in India, focusing more efforts on what works and investigating the impact of sociocultural diversity and cost-effectiveness of various modalities of tobacco control should be our priority.
... Smoking was considered by many to be a quick-fix solution to their stress problems. (14)(15)(16)(17) A study in Kolkata observed that 63% employees had multiple addictions (smoking, chewing tobacco, alcohol, and other forms). As much as 56% of the ''more than one pack-a-day'' smokers and 61% of the ''more than one peg-a-day'' drinkers worked in call centers. ...
Call center sector in India is a relatively new industry and one of the fastest growing sectors driving employment and growth in modern India today. While employment in the business process outsourcing (BPO) sector has meant that young adults are reaching their career milestones and financial goals much earlier than before, surveys and anecdotal evidence show that workers in the BPO sector experience high levels of stress and its related disorders, primarily due to its contemporary work settings. Safeguarding the health of youngsters employed in this new, growing economy becomes an occupational health challenge to public health specialists.
Background: Nicotine dependence, a major public health problem, causes respiratory illnesses like asthma, COPD, chronic bronchitis, pneumoconiosis (e.g. silicosis) and respiratory infections. Occupational exposure of smoke and dust among brick kiln workers, in addition to tobacco addiction result in worsening of lung function and increase the risk of mortality. This study planned to estimate the prevalence of nicotine dependence among tobacco users of a brick kiln factory and identify the factors associated with nicotine dependence among them. Methodology: A cross-sectional study was conducted for a period of one month in a brick kiln of Murshidabad district among 135 adult workers who had been consuming any form of tobacco. Nicotine dependence was assessed by interviewing the participants using Fagerstrom Test for Nicotine Dependence (FTND) and Fagerstrom Nicotine Dependence Scale for smokeless Tobacco (FTND-ST) questionnaire. Results: About, 52.6% were smokers, 24.4% were smokeless tobacco users and 23% were addicted to both. Approximately 73.6% and 78.2% were nicotine dependent among smokers and smokeless tobacco users respectively. Age, illiteracy, initiation of nicotine consumption at an adult age and long duration of consumption were found to be significantly associated with nicotine dependence. Conclusions: A high level of nicotine dependence was found among workers. Awareness generation and behavior change communication is recommended.
In the todays ever growing competitive era of 24x7 working in IT Industries, IT workers are subjected to day night shift working to meet the target of Customers/Employer. Their Focus during this fluctuated working is solely on meeting the given target and ultimately on performance of IT Team and Company. More & more fields are encompassing IT to improve working .Hence IT working growth will be dynamic. But IT being sedentary & cognitional job, along with day night shift working, results in development of different types of health/Stress (mental) problems. Comparison of Health effects with that of Industrial workers is to demonstrate the difference between health factors & extent of occurrence.
Objective The objective of the study was to understand the challenges faced by nicotine-dependent working women who were undergoing mindfulness-based relapse prevention (MBRP) for smoking relapse prevention. Method In this qualitative study, recruitment, and screening of participants were done to meet inclusion criteria. The final sample consisted of eight working women who underwent eight weeks of MBRP. Interviews were conducted post-intervention, and challenges captured. Thematic analysis was conducted to analyze data. Results The themes that emerged as challenges within the session were transitioning through the program, challenges in the practice of mindfulness, and homework. Challenges outside the session included identifying, and coping with triggers, and cravings, and being mindful through them. Conclusion Though MBRP has seen benefits its does not come without challenges. These challenges can be overcome if practitioners address such within their sessions with the clients. These findings give scope for greater research in the area to showcase the best possible results in the space of smoking relapse prevention.
Purpose
– The purpose of this paper is to investigate the behaviors of India’s information technology (IT) and business process outsourcing (BPO) employees in relation to diet, exercise, sleep, stress, and social habits.
Design/methodology/approach
– This was a qualitative research study, using in-depth, semi-structured interviews. Descriptive data were collected from a two-stage purposive sample of 28 IT-BPO employees from three IT companies and two BPOs in Bangalore, India.
Findings
– The majority of interviewees reported having an unhealthy diet and/or sedentary lifestyle. Lack of time due to demanding work schedules was the largest barrier to diet and exercise. Call-centers were described as a social environment with a young workforce.
Research limitations/implications
– Given the qualitative study design and limited sampling frame, results may not be generalizable. However, the qualitative data suggests that India’s young IT-BPO employees may be at greater risk of lifestyle-related diseases than the general population. The data also suggests that interventions incorporating social influence may be a promising solution, particularly at international call centers.
Originality/value
– There is a lack of literature on the lifestyle of IT-BPO employees in India. The results from this study provide qualitative insight on the motives for health behaviors of IT-BPO employees, as well as the barriers and facilitators for leading a healthy lifestyle in this industry. The findings provide the framework for future workplace wellness interventions.
Introduction: Smoking remains the leading cause of preventable death in the United States. The purpose of this investigation was to systematically analyze smoking cessation interventions conducted in worksite settings. Methods: Three researchers conducted a search of CINAHL, MEDLINE, ERIC and Psychology and Behavioral Sciences Collection databases, independently. Eligibility of articles was evaluated by the following criteria: (1) primary research; (2) tobacco/smoking treatment interventions; (3) implemented in worksite settings; (4) conducted in the United States and abroad; (5) used a quantitative design; (6) published between March 2009 and January 2013 (based on articles published after a similar review). Results: A total of 12 articles satisfied the inclusion criteria. Nine programs reported a positive effect on tobacco/smoking treatment. Seven of the interventions were theory-based, with six of these applying the transtheoretical stages of change model. Four of the programs included pharmacotherapy and six incorporated incentives. Conclusions: Worksite smoking treatment intervention design can be improved by incorporation of more robust designs with extended follow-up measures, explicit operationalization of theoretical frameworks, inclusion of ecological theory-based frameworks and integration of fidelity process evaluation. Pharmacotherapy in conjunction with behavior modification appears efficacious; however, the ability of financial incentives to motivate behavior change is still unconfirmed.
To compare the effects of a worksite intervention by the occupational physician offering simple advice of smoking cessation with a more active strategy of advice including a "quit date" and extra support.
Employees of an electrical and gas company seen at the annual visit by their occupational physicians. CRITERIA END POINTS: Smoking point prevalence defined as the percentage of smokers who were non-smokers at one year. Secondary criteria were the percentage of smokers who stopped smoking for more than six months and the difference in prevalence of smoking in both groups.
Randomised controlled trial. The unit of randomisation was the work site physician and a random sample of the employees of whom he or she was in charge. The length of the follow up was one year. Each of 30 work site physicians included in the study 100 to 150 employees.
Among 504 subjects classified as smokers at baseline receiving simple advice (group A) and 591 the more active programme (group B), 68 (13.5%) in group A and 109 (18. 4%) were non-smokers one year later (p=0.03; p=0.01 taking the occupational physician as the statistical unit and using a non-parametric test). Twenty three subjects (4.6%) in group A and 36 (6.1%) in group B (p=0.26) declared abstinence of six months or more. Among non-smokers at baseline, 3.4% in both groups were smokers after one year follow up. The prevalence of smokers did not differ significantly at baseline (32.9% and 32.4%, p=0.75). After the intervention the prevalence of smoking was 30.8% in group A and 28. 7% in group B (p=0.19). An increase of the mean symptoms score for depression in those who quit was observed during this period.
A simple cessation intervention strategy during a mandatory annual examination, targeting a population of smokers independently of their motivation to stop smoking or their health status, showed a 36% relative increase of the proportion of smokers who quit smoking as compared with what can be achieved through simple advice.
In search of less time-consuming methods of smoking cessation Allen Carr' seminars performed at workplaces in Austria were evaluated.
Of all the 357 smokers attending a seminar in summer 2002, 308 (86%), consented to participate in a repeated health survey, including the SF-36 questionnaire. After 3 months 268 (87%) gave computer-aided telephone interviews and 223 (72%) after 1 year. Analysis by logistic regression was done separately for males and females.
The 1-year quit rate was 40% (worst case assumption) to 55% (best estimate). In 96% of quitters an intensive counseling for 6 h without pharmaceutical aid thereafter was sufficient to maintain abstinence for 12 months. A long smoking history or many earlier unsuccessful attempts to quit did not predict failure. The risk of relapse was found higher in young men with a high number of pack-years and in women with good physical fitness but high Fagerstroem score and financial reasons for the intention to quit smoking. While an average weight gain of 3 kg in males was not associated with failure to quit smoking, we found the highest weight gain (4 kg) in females in the group abstinent at 3 months but smoking again at 12 months. In all participants subjective life quality scored by SF-36 improved. In quitters perception of general health improved more.
Group counseling at the workplace was found to be an efficient method of smoking cessation, capable of increasing subjective life quality and health and to smooth the way to smoke-free enterprises.
Workers in information technology (IT)-enabled services like business process outsourcing and call centers working with visual display units are reported to have various health and psycho-social disorders. Evidence from previously published studies in peer- reviewed journals and internet sources were examined to explore health disorders and psycho-social problems among personnel employed in IT-based services, for a systematic review on the topic. In addition, authors executed a questionnaire- based pilot study. The available literature and the pilot study, both suggest health disorders and psychosocial problems among workers of business process outsourcing. The details are discussed in the review.
The author summarizes the US Public Health Service report
Treating Tobacco Use and Dependence: A Clinical Practice Guideline. The guideline is intended to identify empirically based and validated assessments and treatments for tobacco dependence. The 18-member panel that produced the guideline comprised clinicians, scientists, consumers and methodologists. The panel's major conclusions and recommendations include: (1) Tobacco dependence is a chronic condition that often requires repeated intervention. (2) Because effective tobacco dependence treatments are available, every patient who uses tobacco should be offered at least one of these treatments. (3) It is essential that clinicians and health care delivery systems institutionalize the consistent identification, documentation, and treatment of every tobacco user seen in a health care setting. (4) Brief tobacco dependence treatment is effective, and every tobacco user should be offered at least brief treatment. (5) There is a strong dose-response relationship between the intensity of tobacco dependence counseling and its effectiveness. (6) Three types of counseling and behavioral therapies were found to be especially effective and should be used with all patients attempting tobacco cessation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A cross sectional study was done among 200 Information Technology (IT) professionals in the National Capital Region (NCR) to study the computer related health problems and role of ergonomic factors. The computer related morbidity was present in 93% of the study subjects. The visual problems were seen in 76% and musculoskeletal in 77.5% while 35% felt stressful symptoms. The study subjects having inadequate lighting and not using an antiglare had greater visual problem, i.e. 81.3 and 76.3%, respectively. Of the 152 subjects that had visual discomfort, 80.2% did not have the monitor at correct distance. This observation was found to be statistically significant (P<0.05). The musculoskeletal problems were also higher in the study subjects using inappropriate ergonomics. The study has brought forth a very high prevalence of computer related morbidity among IT professionals and it further concluded that all aspects of ergonomic variables appear to be acting in cohesion in relation to computer related heath.
Background:
The workplace has potential as a setting through which large groups of people can be reached to encourage smoking cessation.
Objectives:
1. To categorize workplace interventions for smoking cessation tested in controlled studies and to determine the extent to which they help workers to stop smoking.2. To collect and evaluate data on costs and cost effectiveness associated with workplace interventions.
Search methods:
We searched the Cochrane Tobacco Addiction Group Specialized Register (July 2013), MEDLINE (1966 - July 2013), EMBASE (1985 - June 2013), and PsycINFO (to June 2013), amongst others. We searched abstracts from international conferences on tobacco and the bibliographies of identified studies and reviews for additional references.
Selection criteria:
We selected interventions conducted in the workplace to promote smoking cessation. We included only randomized and quasi-randomized controlled trials allocating individuals, workplaces, or companies to intervention or control conditions.
Data collection and analysis:
One author extracted information relating to the characteristics and content of all kinds of interventions, participants, outcomes and methods of the studies, and a second author checked them. For this update we have conducted meta-analyses of the main interventions, using the generic inverse variance method to generate odds ratios and 95% confidence intervals.
Main results:
We include 57 studies (61 comparisons) in this updated review. We found 31 studies of workplace interventions aimed at individual workers, covering group therapy, individual counselling, self-help materials, nicotine replacement therapy, and social support, and 30 studies testing interventions applied to the workplace as a whole, i.e. environmental cues, incentives, and comprehensive programmes. The trials were generally of moderate to high quality, with results that were consistent with those found in other settings. Group therapy programmes (odds ratio (OR) for cessation 1.71, 95% confidence interval (CI) 1.05 to 2.80; eight trials, 1309 participants), individual counselling (OR 1.96, 95% CI 1.51 to 2.54; eight trials, 3516 participants), pharmacotherapies (OR 1.98, 95% CI 1.26 to 3.11; five trials, 1092 participants), and multiple intervention programmes aimed mainly or solely at smoking cessation (OR 1.55, 95% CI 1.13 to 2.13; six trials, 5018 participants) all increased cessation rates in comparison to no treatment or minimal intervention controls. Self-help materials were less effective (OR 1.16, 95% CI 0.74 to 1.82; six trials, 1906 participants), and two relapse prevention programmes (484 participants) did not help to sustain long-term abstinence. Incentives did not appear to improve the odds of quitting, apart from one study which found a sustained positive benefit. There was a lack of evidence that comprehensive programmes targeting multiple risk factors reduced the prevalence of smoking.
Authors' conclusions:
1. We found strong evidence that some interventions directed towards individual smokers increase the likelihood of quitting smoking. These include individual and group counselling, pharmacological treatment to overcome nicotine addiction, and multiple interventions targeting smoking cessation as the primary or only outcome. All these interventions show similar effects whether offered in the workplace or elsewhere. Self-help interventions and social support are less effective. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low.2. We failed to detect an effect of comprehensive programmes targeting multiple risk factors in reducing the prevalence of smoking, although this finding was not based on meta-analysed data. 3. There was limited evidence that participation in programmes can be increased by competitions and incentives organized by the employer, although one trial demonstrated a sustained effect of financial rewards for attending a smoking cessation course and for long-term quitting. Further research is needed to establish which components of this trial contributed to the improvement in success rates.4. Further research would be valuable in low-income and developing countries, where high rates of smoking prevail and smoke-free legislation is not widely accepted or enforced.
In the workplace, employees need to be protected from the health threats of exposure to environmental tobacco smoke. There is a significant cost to employers associated with employee smoking at work, yet the uptake and development of a well-defined policy on smoking are not widespread, and few policies tackle the issue through promotion of smoking cessation. Such an approach could not only reduce costs associated with smoking at work, but also have a direct impact on public health. GlaxoSmithKline has implemented a voluntary programme of smoking cessation support for its employees in the UK. The 10 week programme offers a series of one-to-one support sessions with a trained occupational health adviser, as well as access to nicotine replacement therapy patches. At 12 months (n = 123), 25 participants (20%) were non-smokers, of whom 19 (15%) stated that they had not smoked at all for the 12 month period. The other six (5%) had relapsed, but had since tried again and quit successfully. An additional three (2%) classed themselves as non-smokers but still smoked occasionally. Fifty-two per cent of participants stated that regular face-to-face contact and monitoring of progress were particularly useful in helping them to stop smoking. This provides compelling support for the active promotion and support of smoking cessation among employees.
Stress: Occupational Health Disorder Amongst Computer Professionals
- P B Shah
- P S Reddy
- S C Hegde
Shah PB, Reddy PS, Hegde SC. Stress: Occupational Health Disorder
Amongst Computer Professionals. Indian J Occup Health 1999;71-3.
The study was supported by the Intramural funding grants of the Tata Memorial Hospital
- Source
- Support
Source of Support: The study was supported by the Intramural
funding grants of the Tata Memorial Hospital; Conflict of Interest:
None declared.
A clinical practice guideline for treating tobacco use and dependence: A US Public Health Service report: The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives
A clinical practice guideline for treating tobacco use and
dependence: A US Public Health Service report: The Tobacco
Use and Dependence Clinical Practice Guideline Panel, Staff, and
Consortium Representatives. JAMA 2000;283:3244-54.
Tobacco cessation among BPO employees
- Mishra
Mishra, et al.: Tobacco cessation among BPO employees