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Narotam Sekhsaria Foundation

Issue

More than 275 million adults in India use tobacco, of which 48 per cent are men and 20 per cent are women. More than one-third of the population over the age of 15 uses tobacco products. Smoking is estimated to cause about 71 per cent of all lung cancer deaths, 42 per cent of chronic respiratory diseases and nearly 10 per cent of all cardiovascular diseases in the country. Tobacco dependence is a two-pronged problem that requires a solution that addresses both the addiction to nicotine as well as the habit of using tobacco. The concept of delivering a cessation service within health care and workplace environments is a very recent development in India. Existing tobacco cessation programmes operate within the ambit of cancer control or de-addiction. To promote the widespread usage of treatment for tobacco dependence, the Narotam Sekhsaria Foundation initiated the Life First programme in 2002.

About the Programme

Life First, the tobacco treatment service initiated by the Narotam Sekhsaria Foundation, helps people suffering from the ill-effects of tobacco to quit their habit. The programme aims to catalyse, build capacity and establish a high-quality, proven tobacco treatment service for individuals from all social strata. It delivers the service through various location-based models and also provides technical support to organisations. This programme also helps to implement a tobacco-free policy and to develop information, education, and communication materials for both providers and patients.

Protocol

Life First attempts to reach out to all current tobacco users by giving them brief advice. Seven counselling sessions are given over a period of 6 months to the patients/clients who enrol in the programme. These patients/clients are offered both face-to-face and over-the-phone counselling services. After signing up for the service, patients are given education materials and a Quit Diary – a workbook to personalise their plan to quit tobacco.

Research

The research conducted at Life First aims to develop and establish robust and context-specific tobacco dependence treatment models that can be delivered through diverse health care settings in India. The programme aims to test these models at multiple sites, while promoting cross-learning between sites to improve the overall quality of tobacco cessation services. To this end, the programme works toward coordinating and supporting research with international partners, NGOs, local government etc., to enhance shared understanding and to advocate for relevant policy change. In the long term, the programme aims to develop a robust resource pool (of researchers, evidence-base and relevant materials) to inform all future tobacco cessation initiatives in low and middle-income countries.

Partners

Prince Aly Khan Hospital MindTemple Salaam Bombay Foundation

Key Models

Life First offers tobacco treatment services through:

Hospitals:
Addressing the issue of tobacco use with inpatients who are admitted with a tobacco-related illness, or with outpatients who are at risk, makes them more receptive to the positive message.
Primary Health Care Centres:
The outreach staff at these primary health care centres create awareness about the ill-effects of tobacco and the availability of services, and also refers patients to appropriate tobacco treatment services.
Government Programmes:
The integration of TTS with DOTS, the government’s tuberculosis control programme, facilitates counselling and follow-up process for tobacco treatment.
Workplaces: A fee-for-service programme, which aims at increasing awareness about the ill-effects of tobacco, curtailing tobacco use and facilitating a tobacco-free work environment.
Communities:
This service comprises of door-to-door awareness programmes among low and middle-income populations, to reach out to them and offer tobacco treatment services through community halls, community libraries, near temples, other foci of congregation.
Schools:
The programme screens students for tobacco and areca nut use and offers them four group counselling sessions (discussing how tobacco use starts, its triggers, behavioural modification and refusal skill) that are followed up for a period of three months to ensure sustained impact.

For a list of locations where these models are being administered, please visit

Training

Life First conducts three types of trainings based on the various levels of intervention:

Tobacco Treatment Specialist Training
– where participants are trained in all aspects of nicotine dependence treatment and are given all the knowledge and skills required to provide effective, evidence-based interventions.
Brief Advice Training
– where participants are trained to effectively ask patients/clients about tobacco use, to advise them to quit tobacco and to refer them to a tobacco treatment specialist.
Sensitisation Programmes
– where participants from hospitals, schools and workplaces are made aware of the ill-effects of tobacco use, the availability of cessation services and the benefits of quitting tobacco.