Tobacco abuse among public transport bus employees in Mumbai, India: A randomized control trial

Abstract

Background: Consumption of tobacco products including smokeless tobacco is a public health problem. Measures of tobacco control along with promotion of tobacco cessation will have a great impact in reducing the burden tobacco-related diseases. The objectives of current paper were to create cancer awareness and understand predictors influencing use of smokeless tobacco among the public transport bus employees. Methods: Around 4000 public transport bus employees in Mumbai were enrolled after obtaining written informed consent. They were randomized in four arms. Pretest and posttest were conducted to assess their knowledge attitudes and practices regarding tobacco use. Employees were given detailed health education regarding hazards of tobacco and were invited for oral cancer screening. The screen positive participants were referred to the nodal hospital for further management. Results: 2118 (52.95%) employees enrolled consumed tobacco in smokeless forms. Only 174 (8.21%) tobacco users used smoking forms. Khaini was the most common form of tobacco used, followed by masheri/gul. The median frequency of use of different tobacco products varied from 2 to 4 per day. The mean age at initiation of tobacco was 25.76 ± 8.46 years. According to the results of the multivariate analysis, married men, above 40 years, bus driver, belonging to Hindu religion, consuming alcohol, and with no family member using tobacco use were at higher risk of being chronic tobacco users. Conclusion: Awareness about hazards of tobacco and stringent laws against use of smokeless tobacco should be implemented to guard the employees from harmful effects of tobacco use.