Journal
THORAX
Volume 72, Issue 2, Pages 167-173Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/thoraxjnl-2016-208732
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Funding
- Wellcome Trust, UK Capacity Strengthening Strategic award
- Public Health Foundation of India (PHFI)
- consortium of UK Universities [6936]
- Cancer Research UK [C1417/A14135]
- UK's National Centre for Smoking Cessation and Training
- Cancer Research UK [14135, 22962] Funding Source: researchfish
- Economic and Social Research Council [ES/G007489/1] Funding Source: researchfish
- Medical Research Council [MR/K023195/1] Funding Source: researchfish
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Background Tobacco use kills half a million people every month, most in low-middle income countries (LMICs). There is an urgent need to identify potentially low-cost, scalable tobacco cessation interventions for these countries. Objective To evaluate a brief community outreach intervention delivered by health workers to promote tobacco cessation in India. Design Cluster-randomised controlled trial. Setting 32 low-income administrative blocks in Delhi, half government authorised ('resettlement colony') and half unauthorised ('J.J. cluster') communities. Participants 1213 adult tobacco users. Interventions Administrative blocks were computer randomised in a 1: 1 ratio, to the intervention (16 clusters; n= 611) or control treatment (16 clusters; n= 602), delivered and assessed at individual level between 07/2012 and 11/2013. The intervention was single session quit advice (15 min) plus a single training session in yogic breathing exercises; the control condition comprised very brief quit advice (1 min) alone. Both were delivered via outreach, with contact made though household visits. Measurements The primary outcome was 6-month sustained abstinence from all tobacco, assessed 7 months post intervention delivery, biochemically verified with salivary cotinine. Results The smoking cessation rate was higher in the intervention group (2.6% (16/611)) than in the control group (0.5% (3/602)) (relative risk=5.32, 95% CI 1.43 to 19.74, p=0.013). There was no interaction with type of tobacco use (smoked vs smokeless). Results did not change materially in adjusted analyses, controlling for participant characteristics. Conclusions A single session community outreach intervention can increase tobacco cessation in LMIC. The effect size, while small, could impact public health if scaled up with high coverage.
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