DOI: 10.5061/dryad.gtht76hj5
title: Quit attempts amongst tobacco users identified in the Tamil Nadu Tobacco Survey of 2015-16: A 3 year follow-up mixed methods study

description: Objectives To determine current tobacco use in 2018-19, quit attempts made
 and to explore the enablers and barriers in quitting tobacco among tobacco
 users identified in the Tamil Nadu Tobacco Survey (TNTS) in 2015-16.
 Setting TNTS was conducted in 2015-16 throughout the state of TN in India
 covering 111363 individuals. Tobacco prevalence was found to be 5.2%
 (n=5208) Participants All tobacco users in eleven districts of TN
 identified by TNTS (n=2909) were tracked after three years by telephone.
 In-depth interviews (n=26) were conducted in a sub-sample to understand
 the enablers and barriers in quitting. Primary and Secondary Outcomes
 Current tobacco use status, any quit attempt and successful quit rate were
 the primary outcomes, while barriers and enablers in quitting were
 considered as secondary outcomes. Results Among the 2909 tobacco users
 identified in TNTS 2015-16, only 724 (24.9%) could be contacted by
 telephone, of which 555 (76.7%) consented.  Of those who
 consented, 210 (37.8%) were currently not using tobacco (i.e. successfully
 quit) and 337 (60.7%) continued to use any form of tobacco. Of current
 tobacco users, 115 (34.1%) never made any quit attempt and 193 (57.3.8%)
 have made any attempt to quit. Those using smoking form of tobacco
 products (aRR=1.2, 95% CI: 1.1-1.4) and exposure to smoke at home
 (aRR=1.2, 95% CI: 1.1-1.3) were found to be positively associated with
 continued tobacco use (failed or no quit attempt). Support from family and
 perceived health benefits are key enablers, while peer influence, high
 dependence and lack of professional help are some of the barriers to
 quitting. Conclusion Two-thirds of the tobacco users continue to use
 tobacco in the last 3 years. While tobacco users are well aware of the
 ill-effects of tobacco, various intrinsic and extrinsic factors play a
 major role as a facilitator and lack of the same act as a barrier to quit.
description: Data were collected from two sources: a) TNTS database (already
 collected in 2015-16) and b) Telephonic survey (conducted in 2018-19). A
 structured questionnaire was used to collect information by telephone
 survey with the respondents of the original TNTS survey, with the items
 broadly covering areas such as current tobacco usage (both smoking and/or
 smokeless), quit attempt(s) and their duration and their intention to
 quit. In addition, socio-demographic and tobacco use related variables
 were extracted from the TNTS. Reported tobacco users of TNTS (N=2909) in
 11 districts of TN were contacted through telephone by a team of trained
 project staff at the Cancer Institute, Chennai. A Standard Operating
 Procedure (SOP) was prepared and followed for telephone survey. Each study
 participant was contacted a maximum of three times at an interval of 30
 minutes in a day. After two calls, a standardized text message was sent
 stating the details of the caller and the purpose of the call.
 Subsequently, the tobacco user was called 30 minutes after the text
 message. This process was repeated again after 7 days (if no contact was
 made in the previous attempt) before labeling it as an unsuccessful
 contact. Response to each call was recorded by the project staff using a
 separate sheet as: no response, disconnected the call, number not
 reachable, number invalid, refused to share information, busy schedule,
 responded to the call and so on. Respondents who were contacted and
 verbally consented to participate were briefed about the purpose of the
 call. The questions were administered over telephone and the responses
 were recorded on a structured questionnaire.