An Integrated Approach to Worksite Tobacco Use Prevention and Oral Cancer Screening Among Factory Workers in Mumbai, India

Background: Tobacco control and cessation interventions are among the most cost effective medical interventions but health systems in low resource countries lack the infrastructure to promote prevention and cessation among tobacco users. Workplace settings have the potential to provide opportunities and access for tobacco prevention interventions.
Methods: This is a single group study evaluating tobacco use prevention and cessation through a structured three stage intervention program for tobacco users comprising education on harmful effects of tobacco, oral cancer screening and behavior therapy for tobacco cessation at the worksite.
Results: All the 739 workers who were invited participated in tobacco awareness program and were screened for oral pre cancer lesions. 291 (39.4%) workers were found to be users of tobacco in some form. Education, gender and alcohol use (p<0.0001) were some of the factors associated with tobacco user status. The prevalence of clinical oral precancer lesions among tobacco users was 21.6%. Alcohol consumption (p<0.001), the type of tobacco consumed (p<0.018), personal medical history of chronic diseases (p<0.007) and combined use of alcohol and tobacco (p<0.001) were some factors found to be associated with presence of oral pre cancer lesions.
Conclusion: An integrated approach for worksite based tobacco use prevention with oral cancer screening program showed good acceptance and participation and was effective in addressing the problem of tobacco consumption among the factory workers.