A randomised controlled trial to evaluate the effectiveness of a culture and disease-specific, patient-centric multi-component tobacco cessation intervention package for the patients attending non-communicable disease clinics in Punjab, India

Background: Developing an infrastructure to support tobacco cessation through existing systems and resources is crucial for ensuring the greatest possible access to cessation services. The present study aims to evaluate theeffectiveness of a newly developed multi-component cessation among tobacco users in Non-Communicable Disease (NCD) clinics, functioning under the National Programme for Prevention & Control of Cancer, Diabetes, Cardiovascular Diseases, & Stroke (NPCDCS) of the Government of India.

Methods: The intervention package consisting of culture- and disease-specific four face-to-face counselling sessions, pamphlets, and short text messages (bilingual) with follow-ups at 3rd, 6th, and 9th months with an endline assessment at 12th months was delivered to the intervention arm of the two-arm- parallel group randomised controlled trial at two selected NCD clinics. Self-reported seven-day abstinence, frequency of use, expenditure in sevendays at each follow-up, FTND score, stage of change and plasma cotinine values were assessed at baseline, follow-ups, and endline (using Liquid Chromatography –Mass Spectrometry), as applicable.

Results: The intervention arm reported a significantly more reduction in self-reported frequency of tobacco use at 6months (mean: 13.6, 95% CI (7.8–19.4)), 9months (mean: 20.3, 95% CI (12.2–28.4)) and 12months (mean: 18.7, 95% CI (8.7–28.7)). The plasma cotinine concentration at endline in the intervention arm was statistically significantly lower than the baseline concentration.

Conclusion: Strengthening existing health systems is crucial for offering cessation support in the resource-restraint setting of LMICs to assist in quitting sustainably.