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Jena P.K.,Project STEPS | Jena P.K.,Heath Systems Research India Initiative | Kishore J.,Maulana Azad Medical College | Pati S.,Indian Institute of Public Health | And 2 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2013

Background: Tobacco use and quit attempts are two key indicators of the Global Adult Tobacco Survey (GATS) that assess quit attempts among current as well as former tobacco users. The relevant data have inherent policy implications for tobacco cessation programme evaluation. This study aimed to review the concepts of quit attempt assessment and quantifying invalid responses considering GATS-India data. Materials and Methods: GATS assessment of tobacco use and quit attempts were examined in the current literature. Two categories of invalid responses were identified by stratified analysis of the duration of last quit attempt among current users and duration of abstinence among former users. Category A included absolute invalid responses when timeframe of assessment of current tobacco use and less than former tobacco use were violated. Category B included responses that violated the unit of measurement of time. Results: Current daily use, current less than daily use and former use in GATS were imprecisely defined with overlapping of time-frame of assessment. Overall responses of 3,102 current smokers, 4,036 current smokeless users, 1,904 former smokers and 1,343 former smokeless users were analyzed to quantify invalid responses. Analysis indicated overall 21.2% (category A: 7.32%; category B: 17.7%) and 22.7% (category A: 8.05%; category B: 18.1%) invalid responses among current smokers and smokeless users respectively regarding their duration of last quit attempt. Similarly overall 6.62% (category A: 4.7%; category B: 2.3%) and 10.6% (category A: 8.6%; category B: 3.5%) invalid responses were identified among former smokers and smokeless users respectively regarding their duration of abstinence. Conclusions: High invalid responses for a single assessment are due to the imprecise definition of current use, former use and quit attempt; and failure to utilize opportunity of direct data entry interface use during the survey to validate responses instantly. Redefining tobacco use and quit attempts considering an appropriate timeframe would reduce invalid responses. Source


Jena P.K.,Project STEPS | Jena P.K.,Heath Systems Research India Initiative | Kishore J.,Maulana Azad Medical College | Sarkar B.K.,University College London | Sarkar B.K.,Siri Fort Institutional Area
Asian Pacific Journal of Cancer Prevention | Year: 2013

Background: The Global Adult Tobacco Survey has 15 key indicators, cigarettes smoked per day (CPD) among daily smokers being one of them. The first wave of GATS in 14 countries indicated that mean CPD use is higher in women than men in India only, which is contrary to the current understanding of tobacco use globally. This study was undertaken to understand the unusual findings for mean CPD use in the GATS-India survey. Materials and Methods: Items B06a and B06b of the GATS India survey questionnaire that collected information on daily consumption of manufactured and rolled cigarettes were analyzed using SPSS software. Exclusive users were identified from these items after excluding the concurrent users of other tobacco products. Cigarette type, exclusive use and gender stratified analyses were made. Consumption of different types of cigarettes among the mixed users of manufactured and rolled cigarettes were correlated. Results: Higher mean number of CPD use among male daily-smokers was observed than their female counterparts in product specific analysis. Mean CPD as per GATS cigarette definition was higher in males than females for exclusive users but a reverse trend was observed in case of non-exclusive users. Use of manufactured cigarettes increased with increase in use of rolled cigarette among the mixed users and around half of these users reported equal CPD frequency for the both types of cigarettes. Conclusions: The anomaly in mean CPD estimate in GATS-India data was due to inclusion of two heterogeneous products to define cigarettes, variation in cigarette product specific user proportions contributing to the average and non-exclusive concurrent use of other tobacco products. The consumption pattern of cigarettes among the mixed users highlights bias in CPD reporting. Definition, analysis and interpretation of 'cigarettes per day' in the GATS India survey need to be improved by redefining cigarettes and making product specific analyses. Source


Sarkar B.K.,University College London | Sarkar B.K.,Siri Fort Institutional Area | Arora M.,Siri Fort Institutional Area | Gupta V.K.,Siri Fort Institutional Area | Srinath Reddy K.,Siri Fort Institutional Area
Asian Pacific Journal of Cancer Prevention | Year: 2013

Background: This study was undertaken to identify the socio-demographic determinants of quit attempts among smokers and smokeless tobacco users to identify correlates of tobacco cessation behaviour in India Materials and Methods: This was a cross-sectional study for the outcome of quit attempts made by current tobacco users in last 12 months in twelve districts in two states. Simple and multivariable logistic regression analysis was used to obtain the odds ratios (ORs) of socio-demographic variables (age, gender, education, occupation, socioeconomic status, community, area, type of family) and tobacco user status (smoker/smokeless). Results: In the combined analysis, a smoker had higher predicted probability of attempting quitting (OR- 1.41,CI 1.14 -1.90), in comparison to a smokeless tobacco user and a tobacco user in the state of Gujarat was less likely to attempt quitting than a user in Andhra Pradesh (OR-0.60, CI 0.47-0.78). The probability of making a quit attempt was higher among tobacco users who were more educated (OR-1.40, CI 1.04-1.94), having a higher socio-economic status (SES) (OR-2.39, CI 1.54-3.69), and belonging to non-agricultural labourer occupational group (OR-1.90, CI 1.29-2.78). The effects were maintained even after adjusting for all other variables. In disaggregated analysis, findings were similar except in smokeless as a separate group, education level was not significantly associated with quit attempts and with lower odds (OR-0.91, CI 0.58-1.42). Conclusions: This is one of the first studies to provide useful insight into potential determinants for quit attempts of tobacco users in India including smokeless tobacco users, exploring the socio-demographic patterning of correlates of quit attempts. Source


Reddy K.S.,Siri Fort Institutional Area | Satija A.,Siri Fort Institutional Area
Progress in Cardiovascular Diseases | Year: 2010

India is in the middle of the epidemiological transition, with the burden of disease shifting towards chronic conditions, of which cardiovascular diseases (CVDs) form a major part. Findings from the Framingham Heart Study (FHS) have tremendous potential to circumvent the projected increase in CVD burden in India, as they highlight the importance of measuring risk in individuals and populations, and preventing future onset of disease. The findings of the FHS have stimulated several cross-sectional studies in India documenting a high and increasing burden of CVD risk factors. These have led to policy level changes in the country, in the form of Framework Convention on Tobacco Control ratification, and the National Program on Diabetes, CVD, and Stroke. There is now need for an Indian cohort study on the lines of the FHS, which can more closely evaluate the use of the FHS risk score among Indians and translate FHS findings into the Indian context. © 2010. Source

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