An interventional study to assess the impact of behavior modification therapy on motivation level for tobacco cessation among adult tobacco users in a resettlement colony of South Delhi

Abstract

BACKGROUND: Tobacco use remains a significant global health challenge, contributing to 8 million annual deaths and potentially reaching 1 billion deaths in the 21st century. Despite taking efforts like India’s National Tobacco Control Program, the country faces a persistent 39% tobacco use prevalence, particularly in low-income communities like those from Madanpur Khadar, Delhi. This study explores the effectiveness of behavior modification therapy in addressing this challenge. MATERIALS AND METHODS: In a community-based trial, 400 adult tobacco users from Madanpur Khadar were enrolled and randomization and allocation concealment were done (CTRI no.: CTRI/2021/06/034298). Participants were randomly assigned to intervention and control groups during the study period of 18 months. Data on sociodemographic characteristics, smoking behaviors, and motivation levels were collected. The intervention included behavior modification therapy, while the control group received brief advice. Motivation levels were assessed using the contemplation ladder, and carbon monoxide levels were measured with piCO + Smokerlyzer. The study adhered to ethical considerations and obtained approval from Jamia Hamdard’s Institutional Ethical Committee. RESULTS: Sociodemographic characteristics revealed a predominantly male (88%) population, aged above 30 years (68.5%), with lower middle class representation (51%). The intervention group exhibited a 7% smoking cessation rate, which is significantly higher than the control group (1%). piCO+ Smokerlyzer confirmed a 41.7% reduction in carbon monoxide levels among participants in the intervention group. High motivation levels correlated with successful quitting, with a 6.5 times higher odds ratio for highly motivated individuals compared to low or moderately motivated ones. CONCLUSIONS: The study highlights the cost-effective impact of behavior modification therapy in promoting tobacco cessation, particularly in resource-constrained settings. The significant association between motivation levels and quitting underscores the importance of tailored interventions in public health initiatives aimed at reducing tobacco use.