Smoking Cessation Intervention in Rural Kerala, India: Findings of a Randomised Controlled Trial
Smoking Cessation Intervention in Rural Kerala, India: Findings of a Randomised Controlled Trial
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DOI：
10.7314/apjcp.2013.14.11.6797
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发表时间：
2013-01-01
影响因子：
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通讯作者：
Sebastian, Paul
中科院分区：
文献类型：
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作者：
Jayakrishnan, Radhakrishnan;Uutela, Antti;Sebastian, Paul
背景：印度农村地区的烟草使用流行率高于城市地区。与设在城市地区的戒烟诊所不同，以社区为基础的戒烟干预有可能覆盖到社区更广泛的区域，以协助农村地区的戒烟工作。本研究旨在评估印度喀拉拉邦农村戒烟干预的有效性。材料与方法：将来自喀拉拉邦农村四个社区发展街区的18-60岁每日吸烟的男性居民随机分为干预组和对照组。干预组接受了多种方法，其中优先考虑面对面访谈和电话咨询。最初分发了关于烟草危害的教育材料。此外，还举行了四轮咨询会议，其中包括与医疗营进行的小组咨询以及由训练有素的医务社会工作者进行的个人咨询。对照组接受了关于烟草危害的一般认识培训，并收到了反烟草传单。在6个月和12个月后评估自我报告的吸烟状况。使用二项回归方法估计与戒烟相关的因素。结果：干预组总体戒烟率为14.7%，对照组为6.8%（相对危险度：1.85,95% CI: 1.05, 3.25）。在12个月结束时，干预区和对照区分别有41.3%和13.6%的受试者吸烟量减少了50%或以上。较低的卷烟/比迪使用量、较低的尼古丁依赖性和因医疗疾病咨询医生是戒烟的统计显著预测因素。结论：严格的戒烟方案可以提高印度农村地区的戒烟率。
Background: Prevalence of tobacco use is higher in the rural than urban areas of India. Unlike tobacco cessation clinics located in urban areas, community-based smoking cessation intervention has the potential to reach a wider section of the community to assist in smoking cessation in the rural setting. The present study aimed to assess the effectiveness of a cessation intervention in rural Kerala state, India. Materials and Methods: Current daily smoking resident males in the age group 18-60 years from four community development blocks in rural Kerala were randomly allocated to intervention and control groups. The intervention group received multiple approaches in which priority was given to face-to-face interviews and telephone counselling. Initially educational materials on tobacco hazards were distributed. Further, four rounds of counselling sessions were conducted which included a group counselling with a medical camp as well as individual counselling by trained medical social workers. The control group received general awareness training on tobacco hazards along with an anti-tobacco leaflet. Self-reported smoking status was assessed after 6 and 12 months. Factors associated with tobacco cessation were estimated using binomial regression method. Results: Overall prevalence of smoking abstinence was 14.7% in the intervention and 6.8% in the control group (Relative risk: 1.85, 95% CI: 1.05, 3.25). A total of 41.3% subjects in the intervention area and 13.6% in the control area had reduced smoking by 50% or more at the end of 12 months. Lower number of cigarettes/bidi used, low nicotine dependence and consultation with a doctor for a medical ailment were the statistically significant predictors for smoking cessation. Conclusions: Rigorous approaches for smoking cessation programmes can enhance quit rates in smoking in rural areas of India.