Clinico-epidemiological profile and barriers to cessation among tobacco users attending a tobacco cessation clinic in Goa.

Background: India is the second largest consumer of tobacco globally, and accounts for approximately one-sixth of the world's tobacco-related deaths. In developed countries, the quit ratio for smoking is about 30%, while in India it is < 5%. Even though tobacco users may be aware of the harmful effects of using the products, they often find themselves unable to quit for various reasons like peer pressure, family or work stress, healthcare access barriers, craving or withdrawal from nicotine, lack of family and workplace support, and dependence. Objectives: To study the profile of tobacco users and to assess the barriers to tobacco cessation among them. Materials and Methods: A mixed-method study was conducted over 3 months on 224 tobacco users. For the quantitative study, the interview administered questionnaire had three parts; (1) Socio-demographic information of the participants (2) Fagerstrom Test for Nicotine Dependence (FTND), and (3) Barriers in tobacco cessation. Focus Group Discussions (FGDs) were conducted to assess the qualitative component of the study. Results: One-third (33.5%) of the participants had initiated tobacco use before the age of 15 years, two-thirds (65.2%) of the patients were referrals from other departments and more than half (58.9%) had never considered quitting before. The most common cause for initiation was peer pressure (51.2%). The barriers to cessation included (1) Peer pressure (2) Stress (3) Need for day-to-day activities, and (4) Idleness. Conclusion: Users cannot be considered as a homogeneous group of people as their barriers differ and require a differentiated approach. Addressing and minimizing the barriers is necessary for compliance with tobacco cessation therapy.