This article turns the spotlight on the START (Stop Tobacco with Assistance and Recover Today) project as a mobile application to enable any health or social worker to get trained in tobacco cessation counseling-TCC. It has been developed based on scientifically proven methods and strategies to help tobacco users successfully quit use of tobacco. It is now available on Play Store, freely downloadable Version 1.0 for Android users
By Dr. Sumedha Kushwaha
PhD Scholar-University of Toronto I Research Assistant- CAMH & OTRU I CEO- GIPHI I Founder- ATTAC, IIDA I PT Professor-Humber College
Toronto, Ontario, Canada
START: Stop Tobacco with Assistance and Recover Today
Globally, tobacco kills 8 million people annually. According to the World Health Organization (WHO), tobacco use kills up to half of its users. The various forms of tobacco include – smoking; smokeless/chewing; moist snuff- which is held in mouth; dry snuff- inhaled through nose; water pipe; and inhaling vapor through an electronic cigarette. It is the nicotine in tobacco products which makes it addictive. Along with its other constituents, it causes Non-Communicable Diseases (NCDs) namely cancer, heart diseases, chronic respiratory diseases, diabetes, and stroke. Each year the majority of deaths are due to direct effects and indirect exposure due to secondhand smoking. More than 80% of the world’s 1.3 billion tobacco users live in low-and middle-income countries (LMICs). Amongst LMICs, India is the second largest producer and consumer of tobacco. According to the Global Adult Tobacco Survey 2 (GATS 2), 10% and 24% of the total Indian population uses smoking and smokeless tobacco respectively.
Interestingly, there is also a huge demand for tobacco cessation services. Data suggests that 38.4% and 33.2% smokers and smokeless tobacco users respectively, made a quit attempt in the past 12 months. 55.4% and 49.6% current smokers and smokeless tobacco users planned or were thinking about quitting tobacco. Evidence suggests that doctors and dentists, who are primary standard care givers in such circumstances have not shown promising knowledge, attitude, practices in tobacco cessation counseling (TCC).
Major barriers to this process are reported as lack of time, under confidence, no skills or training, demotivation due to no remuneration. Additionally, negatively skewed health professional/population ratio creates a huge gap between the demand and supply for TCC service providers. There are significant urban–rural differences in human resources for health with urban areas having four times greater doctor density than rural areas. There is further scarcity of trained mental health professionals, which creates a huge gap between the demand and supply for TCC services. Due to a drastic increase in mobile phone usage, last mile internet connectivity, and innovations in health technology-mobile applications have been proven to be successful in such measures. Evidence further suggests that there are many mobile applications for helping users quit, however, there are very few studies on the use of mobile applications for training health workers to become Tobacco Cessation Counselors, especially in LMICs like India.
Our project START (Stop Tobacco with Assistance and Recover Today) is a mobile application to enable any health or social worker to get trained in TCC. It has been developed based on scientifically proven methods and strategies to help tobacco users successfully quit use of tobacco. It is now available on Play Store, freely downloadable Version 1.0 for Android users.
It has features like:
- Session wise evidence-based counseling protocol in lay language for social workers. Upto three sessions, the health worker gets textual and graphical cues to be delivered in each session.
- Calculator-which helps to calculate financial burden due to tobacco use and monetary benefits due to quitting;
- Calendar to book next appointment;
- Tests: There are inbuilt tests like the Motivation to Quit Scale and the Fagerstrom Nicotine Dependent Test to assess the intention of quitting and intensity of dependence on nicotine.
- Trackers to monitor usage, abstinence, mood, withdrawal symptoms, relapse;
- FAQs: it’s a service which allows social workers clear technical or medical doubts regarding tobacco use and mental health, pregnancy, vulnerable population groups, other substance abuse etc. through a vast database of related knowledge.
https://play.google.com/store/apps/details?id=com.start.gifi is the link to download this application. This is a novel and different from existing solutions, as they are mostly directed towards patients themselves.