dr.srabana zonal 2016

Quitting: in male vs. female users of different types of tobacco at eight months post intervention in a community setting

Dr. Srabana Misra Bhagabaty: Assistant Professor cum In-Charge, Department of Preventive Oncology, Dr. B. Borooah Cancer Institute

Guwahati-16

(Scietific session: oral presentation in 3rd North East Zonal conference of IAPSM and IPHA on 22nd-23rd October 2016)

Dr. Srabana M Bhagabaty

Objectives of this study

To analyze if there is any difference in quit rates depending on the different type of tobacco use at eight months post intervention

To speculate the if the quit rate in female tobacco users of varying patterns tally with their male counterparts

To consider specific intervention procedures towards better quit rate depending on the type of use and user

Methodology

• Community based intervention study

• Study sample : 800

• Duration of the study : one year

• Study period: 2009-2010

Methodology…

• Study area: Assam : It was carried out in South, East, West and Central urban blocks of Guwahati Metro.

• Tool of data collection : Predesigned pretested proforma

• Data entry and analysis: SPSS

Methodology…

The inclusion criteria for the study

Tobacco users of both sex, aged >15 years and permanent residents of study areas willing to take part in the study.

The exclusion criteria were Non users of tobacco, past users of tobacco, tobacco users

of age less than 15 years, not willing to get tobacco cessation intervention, not permanent residents of the study areas.

Methodology…

Staff recruitment – training – survey subject registration

Four Medical social workers (MSWs) wererecruited and trained up

They conducted door to door survey in the study area and registered the study subjects ( 200 study subjects per MSW)

Methodology…

During registration :

Information communication and education materials on tobacco hazards were offeredto the study subjects

A date and time for counseling was fixedaccording to the convenience of thesubjects a keeping in mind time frame ofthe study . Dr. Srabana M

Bhagabaty

Methodology…

Community intervention

:Mode : Tobacco cessation counseling

:BY: The MSW (200 each)

:At : The community setting ,homes of the study

subjects. Dr. Srabana M

Bhagabaty

Methodology…

Follow up

By : Direct contact

Intervals and duration :

0-2 weeks, 2- 4 weeks, 4-6 weeks, 6weeks-2months, 2-3months, 3-4 months, 4- 6 months, 6-8 months.

When contacted for follow up the study subjects ,needed re-counseling was given to them whereneeded

Methodology…

RESULTS

DISCUSSIONS

• The survey covered 750 households

• 87% of these households with a nuclear family

• Persons in the age group >15years and permanent residents of these areas were 2100 out of which 860 were current tobacco users

• 60 of these 860 could not meet the inclusion criteria

Results and discussions….

GENDER DISTRIBUTIONStudy sample showed 4.2: 1, male: female ration

FEMALE649 were male users and 151 were female users of tobacco

literacy status of the study subjects

4%4%3% CollegeHigher secondaryHigh schoolMiddle schoolprimary schoolIlliterate

Results ….

6%5%5%

CollegeHigher secondaryHigh schoolMiddle schoolprimary schoolIlliterate

Females

PATTERN OF TOBACCO USE: MALES

Smokeless 25.4%

Both form 42%

Smoking 33%

• 94.6% female users used of smokeless forms of tobacco

• Only 8 females out of 151 were smokers • No women used both forms

Males are known smokers and females are chewersmale female ratio of smoking form of tobacco use is around 27:1.

• Maximum no of female chewers gave history of use of betel quid

• Out of male users of smokeless tobacco and majority used it in khaini form

• Nearly half (47%) of current smokers and smokeless tobacco users (46%) want to quit tobacco and 38 percent made an attempt to quit tobacco.

Quitting according to type of use irrespective of gender

Habits Users Quitters % Quit

Smoking Habit Only 221 103 46.6

Smokeless Tobacco Habit Only 308 162 52Smoking &

Smokeless Habit 271 110 40.59

Chi square test for the difference of type of use and quitting tobacco (irrespective of gender) showed Chi square=3.036, degree of freedom was 2 with P value 0.2191.

INSIGNIFICANT

Quitting according to type of use: Males

• Habits• Users• Quitters• % Quit• Smoking Habit Only• 221• 103• 46.6• Smokeless Tobacco Habit Only• 308• 162• 52• Smoking & Smokeless Habit• 271• 110• 40.59

Smoking Habit Only

213 103 48.36

Smokeless Tobacco Habit

165 85 51.52

Smoking & Smokeless

271 110 40.59

The association between different tobacco use pattern and quit rate amongst males gave chi square=2.123, degree of freedom 2, P>0.05, INSIGNIFICANT Dr. Srabana M

Bhagabaty

Distribution of female quitters with different tobacco use habit

Smoking Habit Only

8 0 0Smokeless

Tobacco Habit Only

142 78 54.9

Smoking & Smokeless

• On comparing between different use type and quit rate it was found as statistically significant with value of Chi-square statistic 4.311, at degree of freedom 2 and P value was .0379

The difference in quit rates between female smokeless tobacco users and female

smokers was found significant.

• Quit rate was zero for female smokers

• But 54.9% female chewers quitted successfully

No female smokers quitted tobacco where as 46.6 percent male smokers quitted the habit

Conclusions

> Males were found to use both smoking and smokeless forms of tobacco predominantly > Females were predominant users of smokeless forms > Quit rates as such did not differ significantly based upon the type of tobacco use irrespective of sex of the user

Dr. Srabana M Bhagabaty Dr. Srabana M Bhagabaty

Conclusions• No such quit rate difference had been observed in

intra group comparison between male users of different types of tobacco

• In case of female, quit rate for smokers was zero and the difference of quit rates amongst smokers and smokeless tobacco users was.

statistically found to be significant

• Not only female smokers quit less than female chewers in our research significantly but also female smokers alarmingly shoulder high quitting challenges for the cessation service provider than the male smoker counterpart.

Conclusions

RecommendationQuitting behavior difference and disparity

between males and female counterpart needs more research.

Counseling for cessation at both clinic based and community settings should be added by liberal use of NRT and chemo interventions for more challenging patterns of tobacco use for example those who uses both, i.e. smoking and smokeless forms and female smokers.

Recommendation

Capacity development of the tobacco cessation service providers, towards use of Nicotine replacement therapy(NRT) or antidepressants should be given more emphasis on.

> Dr. Amal Chandra Kataki, Director Dr. B.Borooah Cancer Institute > Dr. Sekhar Shalkar , National organisation for Tobacco Eradication India, GOA

> Manoj Kalita,Population based Cancer Registry, Dr. B.Borooah Cancer Institut

Acknowledgement

THANK YOU

dr.srabana zonal 2016

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