title: Establishing a model workplace tobacco cessation program in India.
abstract: BACKGROUND
  Tobacco use is highly prevalent and culturally accepted in rural Maharashtra, India.
  
  
  OBJECTIVE
  To study the knowledge, attitude, and practices (KAP) regarding tobacco consumption, identify reasons for initiation and continuation of tobacco use, identify prevalence of tobacco consumption and its relation with different precancerous lesions, provide professional help for quitting tobacco, and develop local manpower for tobacco cessation activities. SETTINGS, DESIGN, METHODS AND MATERIAL: The present study was conducted for one year in a chemical industrial unit in Ratnagiri district. All employees (104) were interviewed and screened for oral neoplasia. Their socio-demographic features, habits, awareness levels etc. were recorded. Active intervention in the form of awareness lectures, focus group discussions, one-to-one counseling and, if needed, pharmacotherapy was offered to the tobacco users.
  
  
  RESULTS
  All employees actively participated in the program. Overall, 48.08% of the employees were found to use tobacco, among which the smokeless forms were predominant. Peer pressure and pleasure were the main reasons for initiation of tobacco consumption, and the belief that, though injurious, it would not harm them, avoiding physical discomfort on quitting and relieving stress were important factors for continuation of the habit. Employees had poor knowledge regarding the ill-effects of tobacco. 40% of tobacco users had oral precancerous lesions, which were predominant in employees consuming smokeless forms of tobacco.
  
  
  CONCLUSIONS
  Identifying reasons for initiation and continuation of tobacco consumption along with baseline assessment of knowledge, attitudes, and practices regarding tobacco use, are important in formulating strategies for a comprehensive workplace tobacco cessation program.
authors.affiliation: Department of Preventive Oncology, Tata Memorial Hospital, India.
authors.forename: Gauravi A
authors.initials: GA
authors.lastname: Mishra
authors.forename: Surendra S
authors.initials: SS
authors.lastname: Shastri
authors.forename: Pallavi A
authors.initials: PA
authors.lastname: Uplap
authors.forename: Parishi V
authors.initials: PV
authors.lastname: Majmudar
authors.forename: Pallavi S
authors.initials: PS
authors.lastname: Rane
authors.forename: Subhadra D
authors.initials: SD
authors.lastname: Gupta
references.citation: Tob Control. 2006 Jun;15 Suppl 3:iii65-70
references.pmid: 16754949
references.citation: Indian J Med Sci. 2006 Jul;60(7):271-6
references.pmid: 16864911
references.citation: BMJ. 2004 Apr 3;328(7443):801-6
references.pmid: 15070637
references.citation: Int J Cancer. 2003 Nov 1;107(2):285-91
references.pmid: 12949809
references.citation: Bull World Health Organ. 1984;62(2):243-50
references.pmid: 6610492
references.citation: Community Dent Health. 1993 Jun;10 Suppl 1:31-41
references.pmid: 8402306
references.citation: Cancer Detect Prev. 1991;15(5):331-4
references.pmid: 1751941
references.citation: Tob Control. 2003 Dec;12(4):e4
references.pmid: 14660785
references.citation: Br J Cancer. 1997;76(3):390-4
references.pmid: 9252209
references.citation: Cancer Detect Prev. 1986;9(3-4):219-25
references.pmid: 3742502
references.citation: BMJ. 2004 Apr 24;328(7446):977-80
references.pmid: 15066887
references.citation: Am J Public Health. 2005 Jun;95(6):1003-8
references.pmid: 15914825
references.citation: Health Educ Res. 2006 Jun;21(3):355-65
references.pmid: 16740680
references.citation: Am J Surg. 1988 Oct;156(4):273-5
references.pmid: 3177749
references.citation: Public Health. 2000 Sep;114(5):348-52
references.pmid: 11035455
references.citation: Nicotine Tob Res. 2002 May;4(2):149-59
references.pmid: 12028847
references.citation: Tob Control. 1996 Summer;5(2):114-20
references.pmid: 8910992
references.citation: Natl Med J India. 2005 May-Jun;18(3):148-53
references.pmid: 16130619
references.citation: J Assoc Physicians India. 2006 Aug;54:609-12
references.pmid: 16941790
references.citation: BMC Public Health. 2008 Mar 26;8:97
references.pmid: 18366781