Challenges in Indian Women’s Readiness to Quit Smokeless Tobacco Use

Abstract

Introduction: In India, there are few cessation programs for women smokeless tobacco (SLT) users who want to quit.<br />This paper uses Fishbein's IM model to identify women SLT users' challenges to quitting and multilevel correlates of<br />“readiness to quit". Methods: A survey of SLT use among women of reproductive age was conducted in 2010-13 in an<br />urban slum community of Mumbai with a representative sample of 409 married women aged 18 to 40 years using at least<br />one type of SLT daily. Data were analyzed using frequencies, bivariate statistics and logistic regression. Results: Social<br />influences to continue SLT use included husband's use (71%), family influence and positive beliefs and norms about use.<br />Pressure to quit from significant others influenced past quit attempts but media had no effect on reported behavior. Four<br />groups represented different readiness to quit statues based on intention to quit and past quit/reduce attempts. Seventeen<br />percent had no intention of quitting or reducing; their husbands were more likely to be tobacco users. Half of (52%)<br />the sample had attempted to quit/reduce tobacco and intended to do so in the future. These women were depressed.<br />Fifteen percent had tried to quit but did not intend to again. Correlates were positive beliefs and norms about SLT and<br />withdrawal symptoms. Conclusions: Cessation programs should be made available to women, addressing correlates of<br />women's readiness to quit statuses. Results suggest the need for more complex social/contextual approaches to sustained<br />cessation of SLT use including addressing depression and withdrawal, improved media messages and campaigns tailored<br />to women, and support from family members.