Tobacco Menace and Challenges in Quitting Tobacco in an Indigenous Population of Tamil Nadu: A Cross-sectional Survey

Abstract

Introduction: Tobacco usage is one of the leading causes of preventable death and morbidity all over the world. Many indigenous cultures are known to use tobacco as part of their religious or traditional rites. Such practices are usually initiated at a very young age and maintained lifelong in addition to being transmitted from generation to generation. Aim: The aim of the present study was to evaluate tobacco use practices, awareness on health hazards of tobacco use, practice, success of quit attempts, and knowledge on tobacco cessation aids among a tribal population of Narikuravars in Chennai, Tamil Nadu. Materials and Methods: A cross-sectional survey using a selfstyled 14-item questionnaire was conducted from November 2018-December 2018 in two clusters of Narikuravar population in Chennai, Tamil Nadu. The questionnaire consisted of four parts. The first part consisted of three items to assess the awareness of health hazards of tobacco use, the second part consisted of two items to assess current tobacco use practices, the third part consisted of six items to assess quitting practices and factors that were challenging or led to relapse, the last item in this part of the questionnaire was partly open ended and assessed whether participants had motivated any other person to quit using tobacco and what were the reasons they cited in asking others to quit. The fourth part of the questionnaire consisted of three items to assess the awareness on the availability of professional help to aid in quitting tobacco, awareness on cessation aids and awareness on tobacco control laws in India. In addition to this the questionnaire also included assessment of demographic details such as gender, age, education status and occupation. A total of 130 participants over 15 years of age were included in the study following a cluster sampling technique. The principal investigator administered the questionnaire using face-to-face interviews. All the data were entered into Micro Soft Excel and frequency distributions for all the variables was tabulated. Results: In this study, 56.2% of tribal people aged over 15 years were users of tobacco in smoking or smokeless form. Natural tobacco preparation with tobacco leaf, betel leaf, areca nut and slaked lime was the most common form of tobacco used by 57.5% of Narikuravars. Nearly half (49.3%) of Narikuravars had thought of quitting tobacco use but only 14.4% were able to successfully quit tobacco for at least six months without relapsing back to using. A majority of 97.6% of participants were unaware that professional assistance can be sought to help them quit tobacco use, likewise a majority of 91.5% of participants were unaware of the existence of pharmacological or non-pharmacological aids to assist them in quitting tobacco. Conclusion: The present study demonstrated a relatively high awareness on health hazards of tobacco use among a tribal population of Narikuravars in Tamil Nadu. Nearly half of the users of tobacco wanted to quit the habit but a majority were unable to quit tobacco successfully. Knowledge and awareness regarding seeking professional assistance to quit tobacco and tobacco cessation aids was very poor among tribal people indicating the need for health education efforts in these areas, so as to enable tribal people to quit tobacco use more successfully.

Keywords

• gypsies
• habits
• relapse
• smoking
• smoking cessation aids
• tribes