title: Smoking cessation intervention in rural kerala, India: findings of a randomised controlled trial.
abstract: 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.
  
  
  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.
authors.affiliation: School of Health Sciences, University of Tampere, Finland E-mail : jaykrishnan999@gmail.com.
authors.forename: Radhakrishnan
authors.initials: R
authors.lastname: Jayakrishnan
authors.forename: Antti
authors.initials: A
authors.lastname: Uutela
authors.forename: Aleyamma
authors.initials: A
authors.lastname: Mathew
authors.forename: Anssi
authors.initials: A
authors.lastname: Auvinen
authors.forename: Preethi Sara
authors.initials: PS
authors.lastname: Mathew
authors.forename: Paul
authors.initials: P
authors.lastname: Sebastian
mesh_terms: D000293:Adolescent; D000328:Adult; D003376:Counseling; D005500:Follow-Up Studies; D006293:Health Promotion; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012424:Rural Population; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation; D014029:Tobacco Use Disorder / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult