The goal of this study is to test the efficacy of a comprehensive, community-based tobacco control intervention, among disadvantaged youth (10-19 years) living in low income communities of Delhi.
The specific aims of the project are:(1) To conduct a cluster randomized trial, in slum-dwelling and other low income residential communities of Delhi, of non-pharmacologic community led behavioral intervention intended to promote cessation of tobacco use by adolescent consumers of tobacco, in order to evaluate the effectiveness and cost-effectiveness of such interventions;(2) To identify the demographic and psychosocial factors associated with the uptake and cessation of tobacco products by adolescents residing in such communities;(3) To increase the capacity of Indian investigators, research staff, partner NGOs, community leaders and youth self help groups to implement tobacco cessation programs in low resource community settings;(4) To increase the capacity of US investigators to adapt research models and methods validated in developed countries for application in a developing country. Twenty slum clusters of Delhi would be selected to form ten matched pairs, one of each of which would be randomly allocated to a behavioral intervention for tobacco cessation and the other to a control group receiving free eye check-up. The intervention group would receive training for youth peer leaders, adult community leaders and NGO personnel, followed by implementing interactive community based activities that would aim to enhance motivation to quit tobacco use, encourage quit attempts, promote continued abstinence, enhance knowledge around tobacco consumption and tobacco control, develop advocacy skills etc. over a 24 months period. The main outcome measure would compare tobacco cessation rates, between the two trial groups, of young persons (who have remained tobacco free for at least 30 days) and reduce the prevalence rate between the baseline and end- line surveys. Cost-effectiveness (cost per quality-adjusted life year added due to the intervention) would also be assessed. Capacity building activities would include training workshops (for partners and other participants in this research) and preparation of training modules which would be widely disseminated to public health professionals in India. The results of this study are expected to provide information on effectiveness of non-drug community based behavioral interventions for promoting tobacco cessation in disadvantaged youth of low income countries.

National Institute of Health (NIH)
Fogarty International Center (FIC)
Research Project (R01)
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Special Emphasis Panel (ZCA1-SRRB-Y (M1))
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Liu, Xingzhu
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New Delhi
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Harrell, Melissa B; Arora, Monika; Bassi, Shalini et al. (2016) Reducing tobacco use among low socio-economic status youth in Delhi, India: outcomes from project ACTIVITY, a cluster randomized trial. Health Educ Res 31:624-38
Brown 3rd, H Shelton; Stigler, Melissa; Perry, Cheryl et al. (2013) The cost-effectiveness of a school-based smoking prevention program in India. Health Promot Int 28:178-86
Arora, Monika; Tewari, Abha; Dhavan, Poonam et al. (2013) Discussions with adults and youth to inform the development of a community-based tobacco control programme. Health Educ Res 28:58-71
Arora, Monika; Mathur, Neha; Gupta, Vinay K et al. (2012) Tobacco use in Bollywood movies, tobacco promotional activities and their association with tobacco use among Indian adolescents. Tob Control 21:482-7
Dhavan, Poonam; Bassi, Shalini; Stigler, Melissa H et al. (2011) Using salivary cotinine to validate self-reports of tobacco use by Indian youth living in low-income neighborhoods. Asian Pac J Cancer Prev 12:2551-4
Arora, Monika; Stigler, Melissa; Gupta, Vinay et al. (2010) Tobacco control among disadvantaged youth living in low-income communities in India: introducing Project ACTIVITY. Asian Pac J Cancer Prev 11:45-52