Tobacco use among health professionals and their role in tobacco
                        cessation in Nepal

Pokhrel, Babu Ram; Thankappan, KR; Mini, G. K.; Sarma, P. Sankara

doi:10.1016/j.precon.2007.03.003

Cited by 7 publications

(6 citation statements)

References 20 publications

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“… 36 The mean AOI was lower among students compared with the general population. Also, peer influences 19–23 , 38 , 40 , 42 and parental smoking 19 , 20 , 22 , 23 , 47 , 51 were associated with tobacco initiation. However, parental smoking did not show any such association in some other studies.…”

Section: Resultsmentioning

confidence: 95%

Burden, prevention and control of tobacco consumption in Nepal: a narrative review of existing evidence

Khanal¹,

Khatri

2020

International Health

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Tobacco consumption is one of the major public health problems in the world. Annually, 27 100 premature deaths are attributed to tobacco-related diseases in Nepal. Despite enacting different policies and strategies, the prevalence of tobacco consumption is still high. This study aims to synthesize prevalence, factors associated with its consumption and the policy initiatives for prevention and control in Nepal. This review includes peer-reviewed studies retrieved from two databases (PubMed and EMBASE) and published from 2000 to 2018, and policy initiatives on tobacco prevention and regulations in Nepal. A total of 32 studies and 5 policy documents were reviewed. Findings suggest that tobacco consumption was higher among men, illiterates, older people, people living in rural and mountainous areas and those who initiated smoking as adolescents. Peer pressure and parental/family smoking were major contributing factors for tobacco initiation. Policy analysis showed that low excise tax, weak monitoring mechanisms, poor compliance to bans on the advertisement and promotion of tobacco, smoke-free zones and insufficient programs on tobacco cessation were the major factors behind weak implementation of tobacco-control policies. Hence, targeted and high-risk group tobacco-cessation interventions, increasing taxation and strict policy implementation are crucial for effective tobacco prevention and control in Nepal.

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Section: Resultsmentioning

confidence: 95%

Burden, prevention and control of tobacco consumption in Nepal: a narrative review of existing evidence

Khanal¹,

Khatri

2020

International Health

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“…Awareness of the association between smoking and cancer, cardiovascular diseases and respiratory diseases are generally higher [26]. However, it was reported in a previous study from Kerala that close to two thirds (64%) of diabetes patients reported that smoking will not affect the disease and only 10% reported that smoking causes a lot of aggravation of diabetes [27].…”

Section: Discussionmentioning

confidence: 99%

Smoking cessation among diabetes patients: results of a pilot randomized controlled trial in Kerala, India

et al. 2013

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BackgroundIndia has the second largest diabetic population (61 million) and tobacco users (275 million) in the world. Data on smoking cessation among diabetic patients are limited in low and middle income countries. The objective of the study was to document the effectiveness of diabetic specific smoking cessation counseling by a non-doctor health professional in addition to a cessation advice to quit, delivered by doctors.MethodsIn our parallel-group randomized controlled trial, we selected 224 adult diabetes patients aged 18 years or older who smoked in the last month, from two diabetes clinics in South India. Using a computer generated random sequence with block size four; the patients were randomized equally into intervention-1 and intervention-2 groups. Patients in both groups were asked and advised to quit smoking by a doctor and distributed diabetes specific education materials. The intervention-2 group received an additional diabetes specific 30 minutes counseling session using the 5As (Ask, Advise, Assess, Assist and Arrange), and 5 Rs (Relevance, Risks, Rewards, Roadblocks and Repetition) from a non-doctor health professional. Follow up data were available for 87.5% of patients at six months. The Quit Tobacco International Project is supported by a grant from the Fogarty International Centre of the US National Institutes of Health (RO1TW005969-01).The primary outcomes were quit rate (seven day smoking abstinence) and harm reduction (reduction of the number of cigarettes / bidis smoked per day > 50% of baseline use) at six months.ResultsIn the intention to treat analysis, the odds for quitting was 8.4 [95% confidence interval (CI): 4.1-17.1] for intervention-2 group compared to intervention-1 group. Even among high level smokers the odds of quitting was similar. The odds of harm reduction was 1.9 (CI: 0.8-4.1) for intervention-2 group compared to intervention-1 group.ConclusionsThe value addition of culturally sensitive diabetic specific cessation counseling sessions delivered by non-doctor health professional was an impressive and efficacious way of preventing smoking related diabetic complications.Trial RegistrationClinical Trial Registry of India (CTRI/2012/01/002327)

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“…Tobacco use among health professionals is an important barrier to their providing tobacco cessation services. [26] Research has shown that health professionals who are smokers are less likely to promote smoking cessation or engage in tobacco control. Many of them have not received formal training in providing tobacco cessation.…”

Section: Role Of Physiciansmentioning

confidence: 99%

Involvement of health professionals in tobacco control in the South-East Asia Region

Venkatesh

Sinha

2012

Indian J Cancer

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Tobacco use is widely entrenched in the South-East Asia (SEA) Region leading to high morbidity and mortality in this region. Several studies revealed that tobacco use is widespread among youth and school children. Exposure to second-hand smoke was reported as around 50% or more in three countries - Myanmar (59.5%), Bangladesh (51.3%), and Indonesia (49.6%). Health profession students encompassing medical, dental, nursing and pharmacy disciplines, and even qualified health professionals are no exception from tobacco use. While they are regarded as role models in tobacco cessation programs, their tobacco addiction will carry a negative impact in this endeavour. A mere inquiry about the smoking status of patients and a brief advice by doctors or dentists increases quit rates and prompts those who have not thought about quitting to consider doing so. Evidence from some randomized trials suggests that advice from motivated physicians to their smoking patients could be effective in facilitating cessation of smoking. However, the low detection rate of smokers by many physicians and the small proportion of smokers who routinely receive advice from their physicians to quit have been identified as a matter of concern. This paper describes the role and issues of involvement of health professionals in tobacco control. Data from a variety of sources is used to assess the status. Although there are some differences, tobacco use is widespread among the students and health professional students. Exposure to second hand smoke is also a matter of concern. Tobacco-related problems and tobacco control cut across a vast range of health disciplines. Building alliances among the health professional associations in a vertical way will help synergize efforts, and obtain better outcomes from use of existing resources. Health professional associations in some countries in the SEA region have already taken the initiative to form coalitions at the national level to advance the tobacco control agenda. In Thailand, a Thai Health Professional Alliance against Tobacco, with 17 allies from medical, nursing, traditional medicine, and other health professional organizations, is working in a concerted manner toward promoting tobacco control. Indian Dental Association intervention is another good example.

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Tobacco use among health professionals and their role in tobacco cessation in Nepal

Cited by 7 publications

References 20 publications

Burden, prevention and control of tobacco consumption in Nepal: a narrative review of existing evidence

Burden, prevention and control of tobacco consumption in Nepal: a narrative review of existing evidence

Smoking cessation among diabetes patients: results of a pilot randomized controlled trial in Kerala, India

Involvement of health professionals in tobacco control in the South-East Asia Region

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