Summary: | Background
Tobacco and supari (areca nut or
betel nut) use has been reported with a high prevalence among students in
secondary schools in Mumbai, India. Supari, which is classified as
carcinogenic, is one of the most widely consumed addictive substances in India
after nicotine, ethanol and caffeine.
A study was conducted to evaluate
the efficacy of a school-based psychosocial intervention for all forms of tobacco
and supari cessation among students.
Methods
A quasi-experimental trial with
three measurements - at baseline, Post-test1 and Post-test2 was conducted in 12
schools serving students with similar socioeconomic profile in 2015-16. Six
schools were randomly selected for the cessation intervention and 6 matching
schools were selected based on location and medium of instruction in comparison
group. In the interventions schools, students who self-reported tobacco or
supari use at baseline were assigned to receive a 6-session group cessation
intervention designed specifically for adolescents and school settings. All schools
receive a life-skills and tobacco prevention program called Super-Army.
Results
1313 students completed the
baseline in intervention schools; 212 self-reported tobacco/supari use, of
which 133 enrolled and received both Super-Army in classroom and 6 psychosocial
cessation sessions in group setting. In comparison schools, 1320 students
completed baseline; of which 191 reported tobacco/supari use and received only
the Super-Army prevention messages in classroom.
At Post-test 1,
conducted 4 weeks after sessions ended, reported use in intervention schools
dropped by 30% and in comparison schools by 28%. At Post-test 2, conducted 16
weeks later, in intervention schools self-reported use dropped further by 45%.
This was significantly different from comparison schools where users dropped by
13%.
Conclusions
Although classroom-based
life-skills curricula have an immediate impact on tobacco/supari use, the
addition of a specialized cessation intervention, even if psychosocial in
nature without replacement therapy, seems to have a durable effect on reducing
use.
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