Receipt of healthcare provider advice to quit tobacco use among Indian men.

Abstract

Healthcare provider (HCP) advice to quit smoking is an essential component of smoking cessation interventions. The National Family Health Survey (NFHS) is a periodic health survey of the Indian population. In this cross-sectional analysis we compared NFHS 2015-16 to NFHS 2019-21, and examined the prevalence of the HCP advice to quit tobacco and its associated factors among male cigarette and bidi users. The analytic sample included those who had a HCP visit in the past 12 months. We defined quit advice as receiving any advice to quit smoking from a HCP in the last 12 months ("HCP advice to quit"). We compared sociodemographic characteristics of participants between NFHS-4 and 5. We pooled both samples to conduct multivariate logistic regression analysis for the binary outcome of HCP advice to quit, and examined sociodemographic (age, education, caste, occupation), lifestyle and environmental (smoking frequency, alcohol consumption, second hand smoke exposure), health (non-communicable disease diagnosis), and healthcare use (oral examination, health insurance coverage) factors associated with this outcome. Among cigarette and bidi users visiting a HCP, advice to quit significantly improved from NFHS-4 (54.2%) to NFHS-5 (56.7%) (p < 0.025). Being 45-54 years of age (AOR = 1.67, 95% CI = 1.47-1.89), having a non-communicable disease diagnosis (AOR = 1.80, 95% CI = 1.53-2.12), and smoking >10 cigarettes/bidi per day (AOR = 1.44, 95% CI = 1.29-1.60) were significantly associated with HCP advice to quit. Individuals from Scheduled Tribes were less likely to receive HCP advice to quit (AOR = 0.60, 95% CI = 0.50-0.71). While HCP advice to quit increased from NFHS-4 to NFHS-5, it was limited to those who fit the risk factor profile of a middle-aged male with non-communicable diseases. Although the study is limited by self-reported cross sectional data and survey-item differences between NFHS rounds, our findings present a pressing need for interventions to increase HCP advice to quit to other demographics of men who smoke.