Regular article Community-based group intervention for tobacco cessation in rural Tamil Nadu, India: A cluster randomized trial Muthusamy Santhosh Kumar, (M.P.H.) a,b , P. Sankara Sarma, (Ph.D.) a , Kavumpurathu Raman Thankappan, (M.D., M.P.H.) a, ⁎ a Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, South India b WHO-NPSP, Tatanagar, Jharkhand, India Received 8 April 2011; received in revised form 12 October 2011; accepted 19 October 2011 Abstract The objective of this study was to determine the efficacy of community-based group intervention for tobacco cessation. We recruited 400 men (20–40 years) currently using any form of tobacco from 20 villages of the Indian State of Tamil Nadu and randomized them equally into intervention and control groups. A physician offered two sessions of health education 5 weeks apart along with self-help material on tobacco cessation to the intervention group. The control group received only self-help material. The contents of the sessions included tobacco-related health problems, benefits of quitting, and coping strategies for withdrawal symptoms. Follow-up data were available for 92%. Self-reported point prevalence abstinence of 12.5% in the intervention group was significantly higher than the 6.0% in the control group at 2 months. Community-based group intervention has the potential to increase the coverage of tobacco cessation services for men in rural Tamil Nadu. © 2012 Elsevier Inc. All rights reserved. Keywords: Tobacco use cessation; Health education; Group counseling; Rural population; India 1. Introduction Tobacco has been projected to cause 1 billion preventable deaths in the 21st century, of which more than 70% will occur in low- and middle-income countries (Peto & Lopez, 2001). The largest increase in tobacco-related mortality has been projected to occur in India and China (Murray & Lopez, 1997). The annual smoking-associated deaths in India were projected to be 1 million in this decade (Jha et al., 2008). As per the Global Adult Tobacco Survey, the current tobacco use in any form was 47.9% among adult males in India (Ministry of Health and Family Welfare, Government of India, 2010). The prevalence of tobacco use was significantly higher in rural, poorer, uneducated population compared with urban, wealthier, and more educated population (Rani, Bonu, Jha, Jguyen, & Jamjoum, 2003). All forms of tobacco use were increasing in India, and the largest increase was in the age group 15–24 years. (Thankappan & Mini, 2008). Cessation by current smokers is the only way to avoid substantial proportion of tobacco-related deaths worldwide before 2050. Tobacco cessation is rare in most low- and middle-income countries. For example, the quit rate at population level in India was reported to be only 2%. Unless there is widespread cessation among smokers, 450 million deaths will occur in the world by 2050. Prevention of these deaths requires adult cessation (Jha, 2009). Seventy percent of the 1 million smoking-related mortality in India was projected to occur in the middle age of 30–69 years (Jha et al., 2008). The benefits of smoking were found to be largest in those who quit in the younger age group of 25 to 34 years (Doll, Peto, Journal of Substance Abuse Treatment 43 (2012) 53 – 60 Clinical Trial Registration Number CTRI/2010/091/000221. Conflict of interest: Nil. Source of funding: Nil. ⁎ Corresponding author. Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, South India. Tel.: +91 471 2524231; fax: +91 471 2553469/2446433. E-mail addresses: drsanthosmph09@gmail.com (M.S. Kumar), sarma@sctimst.ac.in (P.S. Sarma), kavumpurathu@yahoo.com, thank@sctimst.ac.in (K.R. Thankappan). 0740-5472/11/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.jsat.2011.10.026