Cessation outcomes and healthcare provider advice to quit among tobacco users: A cross-sectional analysis of the 2018–2019 Tobacco Control Policy (TCP) India survey

INTRODUCTION Tobacco cessation is crucial to reducing morbidity and mortality in India. Through a secondary analysis of the Tobacco Control Policy (TCP) India Wave 3 (2018-2019) survey data, we examined cessation outcomes, including successful quitting, quit attempts, use of cessation services, and healthcare provider (HCP) advice to quit, among combustible, smokeless, and mixed (combustible and smokeless tobacco) users.

METHODS We conducted a cross-sectional analysis of the TCP India Wave 3 (2018-2019) survey data. The survey captured self-reported data on tobacco use and cessation using structured questionnaires. Participants included combustible tobacco (cigarette/bidi) users (n=977), smokeless tobacco users (n=5806), and mixed users (i.e. combustible and smokeless tobacco users, n=1157). Weighted prevalence estimates were calculated, and multivariable analysis evaluated factors associated with cessation outcomes.

RESULTS Successful quitting among lifetime tobacco users ranged from 6.3% to 12.4%. Among current users, past quit attempts ranged from 4.8% to 20.9%, and cessation services use in the latest quit attempt ranged from 5.8% to 9.3%. More combustible tobacco users (67.5%) reported receiving HCP advice to quit than smokeless tobacco users (40.5%). Combustible tobacco users aged ≥55 years (adjusted odds ratio, AOR=3.82; 95% CI: 2.06-7.07) reported higher odds of quitting compared to individuals aged 15-39 years. Smokeless tobacco users who reported that their 'partner thinks a lot that they should quit tobacco use' (AOR=2.21; 95% CI: 1.85-2.64) and who received HCP advice to quit (AOR=2.07; 95% CI: 1.65-2.59) had higher odds of attempting to quit than their respective counterparts. Mixed users who perceived tobacco 'caused a lot of damage to their health' had higher odds of receiving HCP advice to quit (AOR=2.47; 95% CI:1.16-5.29) compared to those reporting 'not at all'.

CONCLUSIONS Cessation outcomes and HCP advice to quit are suboptimal across tobacco users. Longitudinal studies are needed to understand the role of anti-tobacco advertising campaigns and spousal support on cessation outcomes.