An integrated Approach to Worksite Tobacco Use Prevention and Oral Cancer Screening Among Factory Workers in Mumbai, india

Abstract

Background: Tobacco control and cessation interventions are among the most cost effective medical interventions but health systems in low resource countries lack the infrastructure to promote prevention and cessation among tobacco users. Workplace settings have the potential to provide opportunities and access for tobacco prevention interventions. Methods: This is a single group study evaluating tobacco use prevention and cessation through a structured three stage intervention program for tobacco users comprising education on harmful effects of tobacco, oral cancer screening and behavior therapy for tobacco cessation at the worksite. Results: All the 739 workers who were invited participated in tobacco awareness program and were screened for oral pre cancer lesions. 291 (39.4%) workers were found to be users of tobacco in some form. Education, gender and alcohol use (p<0.0001) were some of the factors associated with tobacco user status. The prevalence of clinical oral precancer lesions among tobacco users was 21.6%. Alcohol consumption (p<0.001), the type of tobacco consumed (p<0.018), personal medical history of chronic diseases (p<0.007) and combined use of alcohol and tobacco (p<0.001) were some factors found to be associated with presence of oral pre cancer lesions. Conclusion: An integrated approach for worksite based tobacco use prevention with oral cancer screening program showed good acceptance and participation and was effective in addressing the problem of tobacco consumption among the factory workers.

The Prevalence of Tobacco Use among Manufacturing Workers: Findings from the Baseline Survey of the Mumbai Worksite Tobacco Control Study

“…A large (~100,000 individuals) cross-sectional survey conducted in the city of Mumbai [16] also reported that the prevalence of tobacco use varied across occupational categories, with the highest tobacco use observed among unskilled workers (76%) and the lowest among professionals (45%). Studies in other Indian manufacturing worksites also reported high (ranges from 39% to 86%) prevalence of tobacco use among production workers [17][18][19][20][21]. Taken together, these findings indicate that tobacco use prevalence among production workers varies across India and is mostly higher than the prevalence among nonproduction workers or the general population [2].…”

“…Studies in India from worksites [18][19][20][21] and from the general population [16,17,[29][30][31][32] have reported an inverse association between SES (in terms of education and economic index) and tobacco use, with the highest tobacco use among those with lowest SES. In this study, in addition to an increase in current tobacco-use with decreasing education, past tobacco use decreased with decreasing education.…”

“…Effectively addressing health inequalities requires new sets of interventions, which account for disparities in social determinants of health. Worksites also provide an opportunity for sustained peer group support for quitting tobacco and modifications in social norms toward support for not using tobacco, thereby helping workers stay tobacco free, including the convenience of on-site cessation programs for employees [21,38,39].…”

“…Although a few studies in India have documented the association between occupation and tobacco use [16][17][18][19][20][21], with higher rates for unskilled workers, the factors contributing to this disparity are not clear. Furthermore, most global research on the association between occupation and tobacco use relates to smoking [22][23][24], a prevalent form in most countries.…”

Effectiveness of Individual and Group Counseling for Cessation of Tobacco Habit Amongst Industrial Workers in Pimpri, Pune - An Interventional Study

“…Worksite intervention techniques have proved to be more effective than the clinic based intervention techniques (Fiore and Baker, 2011;Hughes et al, 2011;Pimple et al, 2012a;2012b). However this study was unique as the counseling was done by a dentist at the worksite.…”