Challenges in Indian Women’s Readiness to Quit Smokeless Tobacco Use

Document Type: Research Articles


1 Institute for Community Research, 2Hartford Square West, Ste 100, Hartford, USA.

2 ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, India.

3 ICMR-National Institute of Medical Statistics, Ansari Nagar, New Delhi , India.

4 Hartford Square West, Ste 100, Hartford, 4UCONN Health (Medicine), 263 Farmington Avenue, Farmington, CT, USA.


Introduction: In India, there are few cessation programs for women smokeless tobacco (SLT) users who want to quit.
This paper uses Fishbein’s IM model to identify women SLT users’ challenges to quitting and multilevel correlates of
“readiness to quit”. Methods: A survey of SLT use among women of reproductive age was conducted in 2010-13 in an
urban slum community of Mumbai with a representative sample of 409 married women aged 18 to 40 years using at least
one type of SLT daily. Data were analyzed using frequencies, bivariate statistics and logistic regression. Results: Social
influences to continue SLT use included husband’s use (71%), family influence and positive beliefs and norms about use.
Pressure to quit from significant others influenced past quit attempts but media had no effect on reported behavior. Four
groups represented different readiness to quit statues based on intention to quit and past quit/reduce attempts. Seventeen
percent had no intention of quitting or reducing; their husbands were more likely to be tobacco users. Half of (52%)
the sample had attempted to quit/reduce tobacco and intended to do so in the future. These women were depressed.
Fifteen percent had tried to quit but did not intend to again. Correlates were positive beliefs and norms about SLT and
withdrawal symptoms. Conclusions: Cessation programs should be made available to women, addressing correlates of
women’s readiness to quit statuses. Results suggest the need for more complex social/contextual approaches to sustained
cessation of SLT use including addressing depression and withdrawal, improved media messages and campaigns tailored
to women, and support from family members.


Main Subjects