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

Persistent Link:
http://hdl.handle.net/10150/610095
Title:
Smoking cessation among diabetes patients: results of a pilot randomized controlled trial in Kerala, India
Author:
Thankappan, K. R.; Mini, G. K.; Daivadanam, Meena; Vijayakumar, G.; Sarma, P. S.; Nichter, Mark
Affiliation:
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695 011, India; Quit Tobacco India Project, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695 011, India; Medical Trust Hospital, Pandalam, Pathanamthitta, Kerala, India; Family Medicine and Public Health, University of Arizona, Tucson, Arizona, USA
Issue Date:
2013
Publisher:
BioMed Central
Citation:
Thankappan et al. BMC Public Health 2013, 13:47 http://www.biomedcentral.com/1471-2458/13/47
Journal:
BMC Public Health
Rights:
© 2013 Thankappan et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)
Collection Information:
This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.
Abstract:
BACKGROUND:India 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.METHODS:In 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.RESULTS:In 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.CONCLUSIONS:The 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 REGISTRATION:Clinical Trial Registry of India (CTRI/2012/01/002327)
EISSN:
1471-2458
DOI:
10.1186/1471-2458-13-47
Keywords:
Diabetes; Smoking cessation; Counseling; Kerala; India
Version:
Final published version
Additional Links:
http://www.biomedcentral.com/1471-2458/13/47

Full metadata record

DC FieldValue Language
dc.contributor.authorThankappan, K. R.en
dc.contributor.authorMini, G. K.en
dc.contributor.authorDaivadanam, Meenaen
dc.contributor.authorVijayakumar, G.en
dc.contributor.authorSarma, P. S.en
dc.contributor.authorNichter, Marken
dc.date.accessioned2016-05-20T08:58:26Z-
dc.date.available2016-05-20T08:58:26Z-
dc.date.issued2013en
dc.identifier.citationThankappan et al. BMC Public Health 2013, 13:47 http://www.biomedcentral.com/1471-2458/13/47en
dc.identifier.doi10.1186/1471-2458-13-47en
dc.identifier.urihttp://hdl.handle.net/10150/610095-
dc.description.abstractBACKGROUND:India 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.METHODS:In 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 fouren
dc.description.abstractthe 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.RESULTS:In 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.CONCLUSIONS:The 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 REGISTRATION:Clinical Trial Registry of India (CTRI/2012/01/002327)en
dc.language.isoenen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1471-2458/13/47en
dc.rights© 2013 Thankappan et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0)en
dc.subjectDiabetesen
dc.subjectSmoking cessationen
dc.subjectCounselingen
dc.subjectKeralaen
dc.subjectIndiaen
dc.titleSmoking cessation among diabetes patients: results of a pilot randomized controlled trial in Kerala, Indiaen
dc.typeArticleen
dc.identifier.eissn1471-2458en
dc.contributor.departmentAchutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695 011, Indiaen
dc.contributor.departmentQuit Tobacco India Project, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, 695 011, Indiaen
dc.contributor.departmentMedical Trust Hospital, Pandalam, Pathanamthitta, Kerala, Indiaen
dc.contributor.departmentFamily Medicine and Public Health, University of Arizona, Tucson, Arizona, USAen
dc.identifier.journalBMC Public Healthen
dc.description.collectioninformationThis item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at repository@u.library.arizona.edu.en
dc.eprint.versionFinal published versionen
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