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Behavioural support and nicotine replacement therapy for smokeless tobacco cessation in Bangladesh, India and Pakistan: A pilot randomized controlled trial.

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Title: Behavioural support and nicotine replacement therapy for smokeless tobacco cessation in Bangladesh, India and Pakistan: A pilot randomized controlled trial.
Authors: Siddiqui, Faraz, Kanaan, Mona, Croucher, Ray, Bauld, Linda, Fieroze, Fariza, Kumar, Prashant, Mazhar, Laraib, Pandey, Varsha, Jackson, Cath, Huque, Rumana, Iqbal, Romaina, Siddiqi, Kamran
Source: Addiction. Aug2024 Supplement 1, Vol. 119, p1366-1377. 12p.
Subjects: Smoking cessation, Self-evaluation, Employee retention, Nicotine replacement therapy, Research funding, Statistical sampling, Pilot projects, Factorial experiment designs, Randomized controlled trials, Descriptive statistics, Combined modality therapy, Research, Employee recruitment, Smokeless tobacco, Health facilities, Behavior therapy
Geographic Terms: Bangladesh, Pakistan, India, South Asia
Abstract: Background and aims: Smokeless tobacco (ST) use in South Asia is high, yet interventions to support its cessation are lacking. We tested the feasibility of delivering interventions for ST cessation in South Asia. Design: We used a 2 × 2 factorial design, pilot randomized controlled trial with a duration of 26 weeks, including baseline and follow‐up (6, 12 and 26 weeks) assessments. Setting: Two primary health‐care facilities each in Dhaka (Bangladesh) and Karachi (Pakistan) and a walk‐in cancer screening clinic in Noida (India) took part. Participants: Adult daily ST users willing to make a quit attempt within 30 days. Of 392 screened, 264 participants [mean age: 35 years, standard deviation = 12.5, 140 (53%) male] were recruited between December 2020 and December 2021; 132 from Bangladesh, 44 from India and 88 from Pakistan. Interventions: Participants were randomized to one of three treatment options [8‐week support through nicotine replacement therapy (NRT, n = 66), a behavioural intervention for smokeless tobacco cessation in adults (BISCA, n = 66) or their combination (n = 66)] or the control condition of very brief advice (VBA) to quit (n = 66). Measurements Recruitment and retention, data completeness and feasibility of intervention delivery were evaluated. Biochemically verified abstinence from tobacco, using salivary cotinine, was measured at 26 weeks. Findings Retention rates were 94.7% at 6 weeks, dropping to 89.4% at 26 weeks. Attendance in BISCA pre‐quit (100%) and quit sessions (86.3%) was high, but lower in post‐quit sessions (65.9%), with variability among countries. Adherence to NRT also varied (45.5% Bangladesh, 90% India). Data completion for key variables exceeded 93% among time‐points, except at 26 weeks for questions on nicotine dependence (90%), urges (89%) and saliva samples (62.7%). Among follow‐up time‐points, self‐reported abstinence was generally higher among participants receiving BISCA and/or NRT. At 26 weeks, biochemically verified abstinence was observed among 16 (12.1%) participants receiving BISCA and 13 (9.8%) participants receiving NRT. Conclusions: This multi‐country pilot randomized controlled trial of tobacco cessation among adult smokeless tobacco users in South Asia demonstrated the ability to recruit and retain participants and report abstinence, suggesting that a future definitive smokeless tobacco cessation trial is viable. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Label: Title
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  Data: Behavioural support and nicotine replacement therapy for smokeless tobacco cessation in Bangladesh, India and Pakistan: A pilot randomized controlled trial.
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  Data: <searchLink fieldCode="AR" term="%22Siddiqui%2C+Faraz%22">Siddiqui, Faraz</searchLink><br /><searchLink fieldCode="AR" term="%22Kanaan%2C+Mona%22">Kanaan, Mona</searchLink><br /><searchLink fieldCode="AR" term="%22Croucher%2C+Ray%22">Croucher, Ray</searchLink><br /><searchLink fieldCode="AR" term="%22Bauld%2C+Linda%22">Bauld, Linda</searchLink><br /><searchLink fieldCode="AR" term="%22Fieroze%2C+Fariza%22">Fieroze, Fariza</searchLink><br /><searchLink fieldCode="AR" term="%22Kumar%2C+Prashant%22">Kumar, Prashant</searchLink><br /><searchLink fieldCode="AR" term="%22Mazhar%2C+Laraib%22">Mazhar, Laraib</searchLink><br /><searchLink fieldCode="AR" term="%22Pandey%2C+Varsha%22">Pandey, Varsha</searchLink><br /><searchLink fieldCode="AR" term="%22Jackson%2C+Cath%22">Jackson, Cath</searchLink><br /><searchLink fieldCode="AR" term="%22Huque%2C+Rumana%22">Huque, Rumana</searchLink><br /><searchLink fieldCode="AR" term="%22Iqbal%2C+Romaina%22">Iqbal, Romaina</searchLink><br /><searchLink fieldCode="AR" term="%22Siddiqi%2C+Kamran%22">Siddiqi, Kamran</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Aug2024 Supplement 1, Vol. 119, p1366-1377. 12p.
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  Data: <searchLink fieldCode="DE" term="%22Smoking+cessation%22">Smoking cessation</searchLink><br /><searchLink fieldCode="DE" term="%22Self-evaluation%22">Self-evaluation</searchLink><br /><searchLink fieldCode="DE" term="%22Employee+retention%22">Employee retention</searchLink><br /><searchLink fieldCode="DE" term="%22Nicotine+replacement+therapy%22">Nicotine replacement therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Statistical+sampling%22">Statistical sampling</searchLink><br /><searchLink fieldCode="DE" term="%22Pilot+projects%22">Pilot projects</searchLink><br /><searchLink fieldCode="DE" term="%22Factorial+experiment+designs%22">Factorial experiment designs</searchLink><br /><searchLink fieldCode="DE" term="%22Randomized+controlled+trials%22">Randomized controlled trials</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Combined+modality+therapy%22">Combined modality therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Employee+recruitment%22">Employee recruitment</searchLink><br /><searchLink fieldCode="DE" term="%22Smokeless+tobacco%22">Smokeless tobacco</searchLink><br /><searchLink fieldCode="DE" term="%22Health+facilities%22">Health facilities</searchLink><br /><searchLink fieldCode="DE" term="%22Behavior+therapy%22">Behavior therapy</searchLink>
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Bangladesh%22">Bangladesh</searchLink><br /><searchLink fieldCode="DE" term="%22Pakistan%22">Pakistan</searchLink><br /><searchLink fieldCode="DE" term="%22India%22">India</searchLink><br /><searchLink fieldCode="DE" term="%22South+Asia%22">South Asia</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background and aims: Smokeless tobacco (ST) use in South Asia is high, yet interventions to support its cessation are lacking. We tested the feasibility of delivering interventions for ST cessation in South Asia. Design: We used a 2 × 2 factorial design, pilot randomized controlled trial with a duration of 26 weeks, including baseline and follow‐up (6, 12 and 26 weeks) assessments. Setting: Two primary health‐care facilities each in Dhaka (Bangladesh) and Karachi (Pakistan) and a walk‐in cancer screening clinic in Noida (India) took part. Participants: Adult daily ST users willing to make a quit attempt within 30 days. Of 392 screened, 264 participants [mean age: 35 years, standard deviation = 12.5, 140 (53%) male] were recruited between December 2020 and December 2021; 132 from Bangladesh, 44 from India and 88 from Pakistan. Interventions: Participants were randomized to one of three treatment options [8‐week support through nicotine replacement therapy (NRT, n = 66), a behavioural intervention for smokeless tobacco cessation in adults (BISCA, n = 66) or their combination (n = 66)] or the control condition of very brief advice (VBA) to quit (n = 66). Measurements Recruitment and retention, data completeness and feasibility of intervention delivery were evaluated. Biochemically verified abstinence from tobacco, using salivary cotinine, was measured at 26 weeks. Findings Retention rates were 94.7% at 6 weeks, dropping to 89.4% at 26 weeks. Attendance in BISCA pre‐quit (100%) and quit sessions (86.3%) was high, but lower in post‐quit sessions (65.9%), with variability among countries. Adherence to NRT also varied (45.5% Bangladesh, 90% India). Data completion for key variables exceeded 93% among time‐points, except at 26 weeks for questions on nicotine dependence (90%), urges (89%) and saliva samples (62.7%). Among follow‐up time‐points, self‐reported abstinence was generally higher among participants receiving BISCA and/or NRT. At 26 weeks, biochemically verified abstinence was observed among 16 (12.1%) participants receiving BISCA and 13 (9.8%) participants receiving NRT. Conclusions: This multi‐country pilot randomized controlled trial of tobacco cessation among adult smokeless tobacco users in South Asia demonstrated the ability to recruit and retain participants and report abstinence, suggesting that a future definitive smokeless tobacco cessation trial is viable. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=178210489
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1111/add.16515
    Languages:
      – Code: eng
        Text: English
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        PageCount: 12
        StartPage: 1366
    Subjects:
      – SubjectFull: Smoking cessation
        Type: general
      – SubjectFull: Self-evaluation
        Type: general
      – SubjectFull: Employee retention
        Type: general
      – SubjectFull: Nicotine replacement therapy
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Statistical sampling
        Type: general
      – SubjectFull: Pilot projects
        Type: general
      – SubjectFull: Factorial experiment designs
        Type: general
      – SubjectFull: Randomized controlled trials
        Type: general
      – SubjectFull: Descriptive statistics
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      – SubjectFull: Combined modality therapy
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      – SubjectFull: Employee recruitment
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      – SubjectFull: Smokeless tobacco
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      – SubjectFull: Health facilities
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      – SubjectFull: Behavior therapy
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      – SubjectFull: Bangladesh
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      – SubjectFull: India
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      – SubjectFull: South Asia
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              Text: Aug2024 Supplement 1
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