title: Effectiveness of a brief community outreach tobacco cessation intervention in India: a cluster-randomised controlled trial (the BABEX Trial).
abstract: 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.
  
  
  
  To evaluate a brief community outreach intervention delivered by health workers to promote tobacco cessation in India.
  
  
  
  Cluster-randomised controlled trial.
  
  
  
  32 low-income administrative blocks in Delhi, half government authorised ('resettlement colony') and half unauthorised ('J.J. cluster') communities.
  
  
  
  1213 adult tobacco users.
  
  
  
  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.
  
  
  
  The primary outcome was 6-month sustained abstinence from all tobacco, assessed 7 months post intervention delivery, biochemically verified with salivary cotinine.
  
  
  
  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.
  
  
  
  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.
  
  
  
  ISRCTCN23362894.
authors.affiliation: Public Health Foundation of India, New Delhi, India.|Department of Epidemiology and Public Health, Cancer Research UK Health Behaviour Research Centre, University College London, London, UK.
authors.forename: Bidyut K
authors.initials: BK
authors.lastname: Sarkar
authors.affiliation: Department of Epidemiology and Public Health, Cancer Research UK Health Behaviour Research Centre, University College London, London, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: West
authors.affiliation: Public Health Foundation of India, New Delhi, India.
authors.forename: Monika
authors.initials: M
authors.lastname: Arora
authors.affiliation: School of Public Health, Rutgers University, New Brunswick, USA.
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
authors.affiliation: Public Health Foundation of India, New Delhi, India.
authors.forename: K Srinath
authors.initials: KS
authors.lastname: Reddy
authors.affiliation: Department of Epidemiology and Public Health, Cancer Research UK Health Behaviour Research Centre, University College London, London, UK.
authors.forename: Lion
authors.initials: L
authors.lastname: Shahab
mesh_terms: D000328:Adult; D001945:Breathing Exercises; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011204:Poverty Areas; D020340:Tobacco Use Cessation / Q000379:methods*; D016896:Treatment Outcome
keywords: Smoking cessation; Tobacco control