BACKGROUND AND IMPLEMENTATION CHALLENGES: The COVID-19 pandemic has had a devastating impact on India with over 531,000 deaths and nearly 45,000,000 cases. Evidence suggested that tobacco use was associated with higher infection rates and adverse COVID-19 outcomes, proving tobacco use more harmful than ever. LifeFirst, a tobacco dependence treatment programme offers tobacco cessation counselling in healthcare settings. This provided a unique opportunity to assess the changes in tobacco use behavior and cessation outcomes among tobacco users registered for LifeFirst before and during the first two years of COVID-19 pandemic.
INTERVENTION OR RESPONSE: Tobacco users were identified by the staff from nine healthcare facilities catering to urban slums of Mumbai. Current tobacco users willing to quit tobacco voluntarily enrolled in the six-month counselling service. During the preceding year of COVID-19 pandemic, 657 tobacco users registered for the LifeFirst programme while 284 registered in the first year of COVID and 881 in the second year.
RESULTS AND IMPACT: The proportion of registered tobacco users who were smoking decreased during the COVID period from 20.9% to 14.5%. The reported importance of quitting was highest in the first year of COVID. Adherence to the counselling program and the 7-day point prevalence abstinence (PPA) at six months were highest during the first year of COVID (92.4% and 81.3% respectively) as compared to before COVID (78% and 62.4% respectively) and second year of COVID (89.8% and 78.8% respectively). The 7-day PPA was higher among smokers as compared to smokeless users during COVID.
CONCLUSIONS: Changes in tobacco use behavior were observed among users which can be attributed to the public health measures adopted during the COVID-19 pandemic. Tobacco cessation intervention has been successful and should be replicated and scaled up with relevant public health education for promoted of tobacco cessation services.