Deciding protection or provocation: helping young Siddi women translating knowledge into action

Abstract

Background: Tobacco consumption in nonsmoking forms is culturally accepted even among scheduled tribal women. Hence, smokeless forms of tobacco use by women are widely prevalent. Method(s): A cross-sectional study was conducted in six tribal villages of Gujarat, India. Data was collected by interview from 240 Siddi women by home visits. A quasi-experimental study design with two measurements at baseline and 6 months post-intervention to investigate an intervention in 15-25-year-olds. The intervention programme consists of three 1 hour interactive modules and control group. The study questionnaire measured tobacco smoking and consumers, tobacco related cognitions, and gender, social and environmental aspects was designed and pre-tested in advance. The study compared prevalence of smokers and consumers in the two study arms at 6 months after the intervention. Result(s): Prevalence of tobacco use (all forms), smokeless tobacco use and smoking were 54.45%, 53.41%, and 23.14%, respectively. Prevalence of tobacco use was more in late adolescent period. Education showed significant protective effect on tobacco use. Bidi was commonly used for smoking, while pan masala and gutka were preferred smokeless tobacco. Almost all smokers were also using smokeless tobacco. Around 69% women have heard of tobacco prevention message, but only twenty could interpret it correctly. 79% of the study participants successful stopped using tobacco along with significant reduction in frequency or quantity of tobacco consumption observed in all the study participants. The key barriers to quitting were identified as social norms followed by workload and stress. Conclusion(s): Anti-tobacco activities need to scale up for tribal people, with more emphasis on behavior change through group or personal approach. School programs may have some limitation in tribal area due to high school dropout, and low enrolment. Prevention activities need more focus on smokeless tobacco use and bidi smoking.