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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 12:00 PM

Culturally Appropriate Strategies are Required to Promote Smoking Cessation In Kerala, India

AS Pradeepkumar, MBBS, MPH, Sailesh Mohan, MD, MPH, CU Thresia, PhD, and KR Thankappan, MD, MPH. Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College PO, Trivandrum, 695011, India

Objective: Tobacco smoking is a major public health problem in India. Unfortunately, little is known about the intervention strategies that would be effective for tobacco cessation in this country. Thus we decided to investigate appropriate strategies to promote quitting smoking using formative research methods.

Methods: Using a qualitative study design, we conducted 21 in-depth interviews (smokers, non-smokers and key informants selected purposively) and 16 focus group discussions (separate focus groups for smokers with different age and socio economic status and 8 to 12 smokers in each group selected by snowballing techniques) in Kerala, India in 2004. A semi-structured interview schedule was used to elicit strategies and then the pictures and messages rated most effective were identified using written cards in subsequent focus groups.

Results: Among the smoking related problems the foremost concern of smokers was health problems and their highest priority was the problems of children. Cancer, heart disease, tuberculosis, recurrent lung diseases (bronchial asthma, bronchitis) and chronic leg ulcers were the diseases smokers were most concerned about, in the order of importance. Sexual dysfunction and diabetes were not accepted as tobacco-related diseases. Pictures of mouth cancer and chronic leg ulcers were rated as most likely to influence young and middle-aged smokers whereas those of lung cancer and heart attack were thought more effective with older smokers. Pictures of internal organs were unfamiliar to participants and needed explanation. Different pictures with brief explanations were more effective than tobacco facts in text form to address smokers of different age groups.