title: Reducing tobacco use among low socio-economic status youth in Delhi, India: outcomes from project ACTIVITY, a cluster randomized trial.
abstract: To test the efficacy of an intervention to reduce tobacco use among youth (10-19 years old) in slum communities in Delhi, India. This community-based cluster-randomized trial included 14 slums composed of purposely built resettlement colonies and adjacent inhabitant-built Jhuggi Jhopris. Youth in the intervention received a 2 year multiple-component intervention: (a) youth and adult leader training; (b) peer-led interactive activities and outreach; (c) tobacco cessation camps; and (d) enforcement of India's Tobacco Control Law (smoke-free environments and youth access). Overall, no differences between the intervention and control conditions were observed over time; self-reported tobacco use declined in both groups. However, when stratified by type of residence, a significant decrease was observed among youth in the resettlement colonies in the intervention group for overall tobacco use (slope = -0.69) and cigarette and bidi smoking (slope = -0.66), compared to an increase in the control group (slope = 0.24 and 0.12, respectively) (P < 0.001). No differences in smokeless tobacco (SLT) use were observed for either group. Comprehensive community-based interventions that engage youth can be effective in reducing smoking among disadvantaged youth in India. More intensive interventions, like tax increases or large-scale media campaigns, appear warranted for the most marginalized in this context and for SLT products.
authors.affiliation: UT Health at Houston, School of Public Health, Austin Regional Campus, Austin TX, USA melissa.b.harrell@uth.tmc.edu.
authors.forename: Melissa B
authors.initials: MB
authors.lastname: Harrell
authors.affiliation: Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Institutional Area, Gurgaon 122002, India Public Health Foundation of India, August Kranti Marg, New Delhi, India.
authors.forename: Monika
authors.initials: M
authors.lastname: Arora
authors.affiliation: Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Institutional Area, Gurgaon 122002, India.
authors.forename: Shalini
authors.initials: S
authors.lastname: Bassi
authors.affiliation: Public Health Foundation of India, August Kranti Marg, New Delhi, India.
authors.forename: Vinay K
authors.initials: VK
authors.lastname: Gupta
authors.affiliation: UT Health at Houston, School of Public Health, Austin Regional Campus, Austin TX, USA.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Perry
authors.affiliation: Public Health Foundation of India, Delhi NCR, Plot No. 47, Sector 44, Institutional Area, Gurgaon 122002, India Public Health Foundation of India, August Kranti Marg, New Delhi, India.
authors.forename: K
authors.initials: K
authors.lastname: Srinath Reddy
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D010379:Peer Group; D011204:Poverty Areas; D000074606:Smoking Prevention / Q000379:methods*; D012923:Social Class; D064424:Tobacco Use / Q000009:adverse effects / Q000523:psychology*; D020340:Tobacco Use Cessation / Q000208:ethnology / Q000379:methods*; D035862:Vulnerable Populations