LifeFirst: Impact of a school-based tobacco and supari cessation intervention among adolescent students in Mumbai, India

Abstract

INTRODUCTIONThe youth are a vulnerable populationgroup for tobacco-related harms. Schools are an excellent setting for health promotion; yet there is a dearth of schoolbased cessation interventions, rarely evaluated for their impact. Here, we assess the impact of the LifeFirst program: an ongoing tobacco and supari (areca nut) cessation intervention delivered to students from corporation schools in Mumbai city. METHODS We used a prospective quasi-experimental design with an intervention and a control arm embedded within an ongoing LifeFirst program in select schools. We used a difference-in-difference analysis with baseline and endline surveys to assess the program's impact on students' knowledge about harms, students' refusal skills, and prevalence of tobacco/supari use. We report our work using the TREND statement checklist. RESULTS A total of 959 students registered in the LifeFirst program. In our analysis, we included 827 students who completed both the baseline and end-line surveys. Postintervention, we found both tobacco and supari use reduced substantially among the intervention group while tobacco use increased among the control group. The difference-indifference estimates show a statistically significant reduction of 17.9 and 38.1 percentage points in the intervention group for tobacco and supari use respectively, beyond the reduction in the control group. CONCLUSIONS The LifeFirst program was successful in reducing tobacco and supari use among the study participants and protected students in the intervention group against new uptake of tobacco. It helped improve knowledge score and refusal skills among students. Implementation and evaluation of similar school-based programs should be considered as part of a multi-strategy approach to reducing tobacco use among young people.

A Review of Intervention Strategies for Areca Nut Use Cessation

“…One study also evaluated the feasibility of providing psychological intervention. 26 Two Indian studies 31,32 developed a school-based psychosocial cessation intervention plan to reduce AN intake among school children. Most studies demonstrated an increase in awareness related to the harms of AN, motivation to quit, and a reduction in AN use.…”

“…A prospective quasi-experimental study on 827 students in Mumbai, India, aimed to understand the impact of a school-based tobacco and AN (supari) cessation intervention among adolescent students. 31 The intervention was conducted for 7th, 8th, and 9th grade students using LifeFirst, a standardized tobacco and supari cessation program conceived and implemented by the Narotam Sekhsaria Foundation, India, since 2012, which includes the delivery of six group-based education and counseling sessions by trained counselors. The program aimed at providing educational intervention to corporation-funded/managed (local government) schools in Mumbai.…”

Adolescents and E-cigarettes in India: A Qualitative Study of Perceptions and Practices

“…LifeFirst, a school-based tobacco-cessation program, initiated by Narotam Sekhsaria Foundation in coordination with Salaam Bombay Foundation helps adolescent tobacco-users to quit the habit through evidence-based counselling (Bhojani et al, 2021). During the course of implementing this cessation program, e-cigarette availability and use was reported by students.…”