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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

Quit behavior among patients in Kerala, India

AS Pradeepkumar, MBBS, MPH, CU Thresia, PhD, Sailesh Mohan, MD, MPH, 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: No studies are available from Kerala on the impact of illness on smoking behavior. Therefore we studied smoking behavior among various categories of patients in a rural setting of Kerala, India.

Methods: We conducted in-depth interviews with 61 participants (33 smokers, 19 non-smokers and 9 key informants selected purposively) and six focus group discussions (79 participants, different ages and both sexes) to study smoking behavior before, during and after recovery from different types of illnesses.

Results: Older patients preferred bidis while youngsters preferred cigarettes. The mean number of cigarettes and bidis smoked daily was 6.2 and 16.3 respectively. Bidis were reported to be less harmful since they are natural, shorter and thinner. In spite of family pressure to quit smoking, most of the smokers continued smoking even after the detection of diseases like asthma, tuberculosis, hypertension, diabetes and peptic ulcers. The majority of the smokers continued smoking even when they were admitted to a hospital. All smokers who had cancer, acute myocardial infarction, severe asthma and those who underwent some surgery quit smoking immediately after the diagnosis or surgery. However, the majority of patients restarted smoking after recovery from the illness. Resumption was less common among patients with cancer and myocardial infarction and was earlier among older patients. Smokers who feared death from illness, who thought of distressing symptoms on resumption, who received personalized advice from physician and who thought of the implications of illness on family members continued abstinence from smoking for longer periods of time.