Hypertension and its correlates among pregnant women consuming tobacco in India: Findings from the National Family health Survey-4.

Background: Hypertension (high blood pressure) during pregnancy has significant implications on maternal and perinatal morbidity and mortality. Tobacco use during pregnancy amplifies this burden and increases the risk of hypertensive disorders along with adverse birth outcomes. The current study aimed to evaluate the joint risk atpopulation-level of tobacco use and hypertension among pregnant women in India. Methodology: Data of 32,428 "currently pregnant" women aged 15-49 years was obtained from the National Family Health Survey (NFHS-4) 2015-16to estimate bivariate (tobacco user vs. non-user) and binomial logistic regression analysis in order to get odds ratios of having hypertension. The analysis included socio-demographic variables such as the respondent's age, type of residence, wealth index, and education status. Results: Prevalence of hypertension among pregnant tobacco users (7.5%) was significantly higher than that of non-users (6.1%). The unadjusted odds of having hypertension were 1.17 (95% CI: 1.02-1.35) times among tobacco users than non-users and increased with age (p < 0.001) and in rural areas (p = 0.02) after adjusting for other covariates. However, it varied inversely with education status (p > 0.05; NS) and wealth quintile (p = 0.01). Conclusion: The present study identifies the higher co-existence of hypertension among tobacco-using pregnant women and highlights the need for tobacco control/cessation and hypertension prevention and management during pregnancy considering socio-demographic disparities.

Comparative effectiveness of two behavioral change intervention packages for tobacco cessation initiated in the tertiary care setting of North India-protocol for a two-arm randomized controlled trial.

BACKGROUND: To reduce the global burden of tobacco use, clinical guidelines support behavioral therapy and pharmacotherapy as preferred interventions for tobacco cessation. The evidence-based behavioral interventions has consistently shown to be impactful in community settings; however, its efficacy has not been established in hospital settings. The current study aims to investigate impact of trans-theoretical-based behavioral intervention package on tobacco users suffering from non-communicable diseases attending tertiary care settings of North India. METHODS/DESIGN: A two-arm randomized controlled trial (RCT) in a tertiary healthcare hospital will be performed. A total of 360 tobacco users attending NCD clinics in four departments, cardiology, neurology, pulmonary medicine, and ENT (otolaryngology), will be recruited over a period of 3 months. After ascertaining the eligibility criteria, they will be followed up to 6 months (1, 3, 6) for their tobacco use status, readiness to quit, nicotine dependence, stage of behavior change, and self-reported and biochemical validation (urine cotinine) for tobacco abstinence. Assignment of intervention including allocation concealment, sequence generation, and blinding will be done as per SPIRIT guidelines for RCT protocols. DISCUSSION: As no strong evidence exists about the effectiveness of tobacco cessation intervention in tertiary settings, the current study will build evidence about the similar interventions in such settings. TRIAL REGISTRATION: CTRI/2019/09/021406.

Quality of life of tobacco users- A correlation with duration of use and nicotine dependence.

BACKGROUND: Few studies have investigated the relationship between health-related quality of life and nicotine dependence, while none are from India. This study aims to explore the quality of life among patients with nicotine dependence and examine the clinical and demographic correlates of quality of life. METHOD: This was a cross-sectional study in which 130 active nicotine dependence individuals were interviewed. Participants were selected using random sampling from the various clinical department of a tertiary health care setting of Northern India. Information about the quality of life and severity of nicotine dependence was assessed using SF-12 and Fagerstrom test for Nicotine Dependence questionnaire. One way ANOVA test compared the means among different tobacco users, while Pearson or Spearman tests assessed the correlation between the quality of life and nicotine dependence. RESULTS: The mean age of the respondents in the study was 42.72 (SD = 15.68); with 66% using smoking tobacco, 53.07% had a high dependence towards tobacco. We observed a negative correlation between the physical health component and years of regular use (r = -0.503, p < .001). There was also a negative correlation between FTND score and physical health component (r = -.180, p = .049). CONCLUSION: Duration of tobacco use and the severity of nicotine dependence negatively influence health-related quality of life in treatment-naive individuals.