Online Program

Contextual challenges to smokeless tobacco cessation among vulnerable urban Indian women

Monday, November 4, 2013

Jean Schensul, PhD, Institute for Community Research, Hartford, CT
Saritha Nair, Ph.D., National Institute for Research in Reproductive Health, Mumbai, India
Sameena Bilgi, M.Phil., National Institute for Research in Reproductive Health, Mumbai, India
This presentation describes a systemic approach to smokeless tobacco cessation among vulnerable women in India, a country with high production, use and morbidity/mortality associated with SLT. Women's tobacco use is under-researched and ranges from 18% to more than 65%, especially among poor women with limited education. Methods: A team of Indo-US researchers conducted a mixed methods study in a Mumbai slum. Qualitative/spatial data were collected on SLT accessibility, availability, promotion and social norms. Data on patterns of use, correlates of use, and quitting were collected through a survey of 408 users aged 18 - 40. Results: Tobacco products are accessible and available in 68 cheap brands. Social norms and cultural practices endorse use. Women used up to 4 types of tobacco, 98% daily. Women's use was associated with husband's use (R=.250, sig. 01) and use by close associates) (R=.127; sig. .01). 60% had tried to reduce use of any product in the past year but could not and 36% had tried unsuccessfully to quit SLT . 77% thought it difficult to quit and 1/3 of users said it was not possible to quit. 60% said husband or family member told them to quit but when asked about help for quitting, 99% said only self determination could help them. Discussion: Tobacco control efforts have not succeeded in reducing use among poor women. Besides lack of cessation support, globally there are no successful approaches to SLT cessation Changing availability accessibility, social norms and social influence are the current best approaches to prevention/cessation.

Learning Areas:

Public health or related research
Social and behavioral sciences
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Describe factors contributing to smokeless tobacco use among low income women in urban India Identify barriers to smokeless tobacco cessation in vulnerable S. Asian women Design multilevel interventions to enable SLT cessation in vulnerable S. Asian women in limited resource areas

Keyword(s): Tobacco Control, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Because I have been funded by NIH to conduct substance abuse research for fifteen years, and tobacco research including this study for the past four years. In addition I am a well published methodologist with seven books on mixed methods research in the social and epidemiology sciences, and a public health/tobacco control researcher and advocate.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.