Kaur Jagdish, Sachdeva Kuldeep S, Modi Bhavesh, Jain Dinesh C, Chauhan Lakhbir S, Dave Paresh, Singh Rana J, Wilson Nevin
Ministry of Health and Family Welfare, Government of India, India.
Department of Community Medicine and Project Manager, State Tobacco Control Cell, Government of Gujarat, India.
WHO South East Asia J Public Health. 2013 Jan-Mar;2(1):28-33. doi: 10.4103/2224-3151.115833.
There is an enormous health burden caused by the co-prevalence of tuberculosis (TB) and tobacco use in India. This intervention study was undertaken in district Vadodara, Gujarat, India to promote tobacco cessation by integrating 'brief advice' for tobacco cessation in TB patients who were tobacco users and registered for treatment under TB control programme, based on the tested strategies advocated by World Health Organization (WHO) and the International Union against Tuberculosis and Lung Diseases (The Union).
Brief advice for tobacco cessation based on five A's, advocated by the WHO and the UNION was incorporated into the on-going TB Control programme in India in the year 2010. The tools were developed for education, training and capturing data. All the registered TB patients receiving directly observed treatment short-course (DOTS) who used tobacco in any form were offered brief advice during routine interaction for treatment.
A total of 46.3% of TB patients, predominantly males (89.6% males and 10.3% females) were current users of tobacco; 39.1% used smokeless tobacco, 35.9% were smokers and 25% were dual users, that is, smoked as well as used smokeless tobacco. At the end of treatment, of the 67.3% patients who were offered brief advice, quit tobacco use, 18.2% re-lapsed while 14.5% were lost to follow-up.
A significant numbers of TB patients use tobacco with adverse impact on TB control programmes. Our study shows that it is feasible to introduce 'brief advice' strategy as a cost effective intervention for tobacco cessation among TB patients with careful monitoring.
在印度，结核病（TB）与烟草使用并存造成了巨大的健康负担。本干预性研究在印度古吉拉特邦瓦多达拉区开展，旨在根据世界卫生组织（WHO）和国际防痨和肺部疾病联盟（防痨联盟）倡导的经过验证的策略，通过将针对吸烟结核病患者的“简短建议”纳入结核病控制项目中，以促进戒烟。
2010年，基于WHO和防痨联盟倡导的“五个A”戒烟简短建议被纳入印度正在实施的结核病控制项目中。开发了用于教育、培训和收集数据的工具。所有接受直接督导下的短程治疗（DOTS）且以任何形式使用烟草的登记结核病患者，在常规治疗互动期间都获得了简短建议。
共有46.3%的结核病患者为当前烟草使用者，其中男性占主导（男性占89.6%，女性占10.3%）；39.1%使用无烟烟草，35.9%为吸烟者，25%为双重使用者，即既吸烟又使用无烟烟草。在治疗结束时，接受简短建议的患者中有67.3%戒烟，18.2%复发，14.5%失访。
大量结核病患者使用烟草，对结核病控制项目产生不利影响。我们的研究表明，引入“简短建议”策略作为一种具有成本效益的干预措施，在仔细监测下帮助结核病患者戒烟是可行的。
