PT  - JOURNAL ARTICLE
AU  - Bidyut K Sarkar
AU  - Robert West
AU  - Monika Arora
AU  - Jasjit S Ahluwalia
AU  - K Srinath Reddy
AU  - Lion Shahab
TI  - Effectiveness of a brief community outreach tobacco cessation intervention in India: a cluster-randomised controlled trial (the BABEX Trial)
AID  - 10.1136/thoraxjnl-2016-208732
DP  - 2017 Feb 01
TA  - Thorax
PG  - 167--173
VI  - 72
IP  - 2
4099  - http://thorax.bmj.com/content/72/2/167.short
4100  - http://thorax.bmj.com/content/72/2/167.full
SO  - Thorax2017 Feb 01; 72
AB  - Background Tobacco use kills half a million people every month, most in low–middle income countries (LMICs). There is an urgent need to identify potentially low-cost, scalable tobacco cessation interventions for these countries.Objective To evaluate a brief community outreach intervention delivered by health workers to promote tobacco cessation in India.Design Cluster-randomised controlled trial.Setting 32 low-income administrative blocks in Delhi, half government authorised (‘resettlement colony’) and half unauthorised (‘J.J. cluster’) communities.Participants 1213 adult tobacco users.Interventions Administrative blocks were computer randomised in a 1:1 ratio, to the intervention (16 clusters; n=611) or control treatment (16 clusters; n=602), delivered and assessed at individual level between 07/2012 and 11/2013. The intervention was single session quit advice (15 min) plus a single training session in yogic breathing exercises; the control condition comprised very brief quit advice (1 min) alone. Both were delivered via outreach, with contact made though household visits.Measurements The primary outcome was 6-month sustained abstinence from all tobacco, assessed 7 months post intervention delivery, biochemically verified with salivary cotinine.Results The smoking cessation rate was higher in the intervention group (2.6% (16/611)) than in the control group (0.5% (3/602)) (relative risk=5.32, 95% CI 1.43 to 19.74, p=0.013). There was no interaction with type of tobacco use (smoked vs smokeless). Results did not change materially in adjusted analyses, controlling for participant characteristics.Conclusions A single session community outreach intervention can increase tobacco cessation in LMIC. The effect size, while small, could impact public health if scaled up with high coverage.Trial registration number ISRCTCN23362894.