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Background: Fishing forms one of the essential livelihood options of inhabitants of the coastal line of the country. It is a stressful and hazardous occupation making fishermen prone to multiple lifestyle diseases. A number of researches have revealed that modifiable risk factors of NCDs are prevalent and are associated with NCDs, including hypertension among fishermen. Risk factors contributing to these include; tobacco and alcohol consumption, unhealthy dietary habits and obesity Objective: To identify the socio-demographic and lifestyle related risk factors among hypertensive fishermen at baseline of an interventional study Methodology: Baseline data for an interventional study was collected among hypertensive fishermen. Participants were recruited from Malpe and Kaup villages of Udupi district for the intervention and routine care arms respectively using a purposive sampling method identified from existing database. Data was collected using a pre-tested questionnaire using standard protocols. A health educational video was then shown to the participants of the intervention arm. The baseline data of both arms was entered and analysed using SPSS Version.26.0. Results: The mean (±SD) age of 112 participating fishermen from both study arms was 58.53 (± 8.72) years. Around 62.5% and 37.5% fishermen had blood pressure in grade 2 and grade 1 range respectively. More than half (61.6%) were ever tobacco users with 50.9% indulging in the habit of smokeless tobacco chewing. Majority (90.2%) were consumers of alcohol with 33% users indulging in hazardous drinking and showing dependence patterns. Nearly three-fourth (70.6%) fishermen were found to be obese and only 1.8% showed a low risk of cardiovascular diseases based on their waist-hip ratio. Conclusion: Risk factors for hypertension and other NCDs like substance use and central obesity were found in more than half of the hypertensive fishermen. Novel interventions facilitating behavioural modification in such occupational groups is essential

Background: Substance Use disorders (SUD) are commonly encountered in general medical practice which include people of all ages and socioeconomic groups. In these circumstances, Screening and Brief Intervention (SBI) can be a useful tool for managing the disease burden in primary care setting. There is a need to investigate the hurdles and enablers that act as a catalyst for integrating Screening and Brief Intervention in primary health care practice Objectives: To explore the barriers and facilitators for implementing screening and brief intervention (SBI) for SUD at primary health care settings Methodology: A written informed consent was obtained from the subjects after briefing about the topic and interview was initiated with the help of an interview guide. The interview was recorded using an audio recorder. The discussion was written in the vernacular language and translated verbatim. Inductive thematic coding was applied to analyse the data Results: A total of 10 participants were interviewed which included four Medical Officers (MO), two Auxiliary Nurse Midwives (ANMS), one each Medical Social Worker (MSW), Tobacco Cessation Cell Consultant, Counsellor and substance user. Some challenges to integrating screening services included lack of manpower, hesitance to reveal substance use by women and identifying trained health care providers to seek assistance for quitting. Facilitators of Screening and brief intervention delivered at Primary Care level includes a favourable attitude of the health care provider, awareness among doctors about harmful effects of substance use and patients’ good rapport with field workers Conclusion: This study’s results point towards a multi-pronged approach like involvement and capacity building of different health care providers like Accredited Social Health Activist (ASHA), ANMs and MO along with encouraging community participation for integrating Screening and Brief Intervention in this setting.

Background: Patients with substance use disorders are common in general medical practice and are a major risk factor for several non-communicable diseases. Appropriate screening is a vital step for providing brief interventions which can provide a good opportunity to tackle this crisis and in achieving target 3.5 of the sustainable development goal which includes strengthening the prevention and treatment of substance abuse. Objectives: To study the magnitude of substance use and factors associated with it among people seeking health care services at primary care settings. Methods: The cross-sectional study recruited people seeking services at primary care settings to screen for substance users (SU) and determine the associated factors. The data was collected using a pretested semi-structured questionnaire including socio-demographic characteristics, health status and the Alcohol, Smoking and Substance Involvement Screening Test tool. Results: The study showed that 43.4% of the participants were SU. The current use of smokeless tobacco was higher compared to tobacco smoking (21.3% and 4.7%). The multivariate logistic regression showed that advancing age (AOR: 2.61 and 95% CI of 1.01–6.79), male gender (AOR: 705 and 95% CI of 4.25–11.70), primary and middle school (AOR: 3.24 and 95% CI of 1.52–6.92) literacy status, unemployed (AOR: 0.49 and 95% CI of 0.25–0.95), religion and other backward caste (AOR: 2.42 and 95% CI of 1.37–4.30) were significant correlates of SU. Conclusion: Substance use was reported by two-fifths of the participants seeking services at primary care centres in our study and stresses the need for incorporating brief interventions to prevent higher degrees of dependence and its complications. [ABSTRACT FROM AUTHOR]

INTRODUCTION In India there is insufficient knowledge of the risks associated with tobacco use. Increasing awareness of these risks is critical, with pictorial warnings on tobacco packs a cost-effective way to communicate this information. We explored perceptions of the current warning, 'Tobacco causes cancer', displayed on packs in India and four novel warnings about other potential impacts of tobacco use including social, financial, and environmental, but also complications with diabetes. As loose cigarette sales are common in India, we also explored perceptions of warnings on cigarette sticks. METHODS A cross-sectional survey of college students aged ≥18 years in Karnataka, India, was conducted between January 2019 and February 2020. Participants were asked about salience, believability, and cognitive processing of warnings currently on packs. They were then shown an image of one current and four novel warnings and asked about their perceived effectiveness in preventing uptake and reducing and stopping tobacco use. They were then asked about warnings on cigarette sticks. RESULTS Most participants (70.2%) recalled warnings on packs and considered them believable (55.7%), but only 12.0% read and 12.4% thought about them often. Warnings about the health impacts of tobacco use were viewed as most effective in preventing uptake, and reducing and stopping tobacco use. Nevertheless, at least a third of participants rated warnings pertaining to financial, social, and environmental impacts effective in preventing uptake, and reducing and stopping tobacco use. Approximately one-fifth (22.0%) thought that warnings on cigarette sticks would deter initiation. CONCLUSIONS Our results suggest that health warnings are perceived as most effective in discouraging tobacco use among college students in Karnataka. While viewed as less effective than health warnings, novel non-health related messages were viewed as effective in preventing uptake, and reducing and stopping tobacco use by at least one in three participants. Warnings on cigarette sticks may help complement warnings on cigarette packs. [ABSTRACT FROM AUTHOR]

INTRODUCTION In India, the retail prices of bidis and cigarettes varied between the two Global Adult Tobacco Surveys (GATS) conducted in 2009-2010 and 2016-2017. The relationship between the retail price of smoked tobacco products and their use is unclear for India. Our study thus aimed to use available datasets to investigate the association between the retail price and current smoking status of bidis and cigarettes in India. METHODS Current smoking status data for bidis and cigarettes were obtained from the two GATS rounds. The average state-level retail prices of bidis and cigarettes were obtained from India's Consumer Price Index- Industrial Workers database. Descriptive statistics were used to describe current smoking status patterns. Generalized Linear Mixed Models were used to investigate the association between the retail prices and current smoking status of bidis and cigarettes. RESULTS For cigarettes, an increase in the average retail price by one Indian Rupee was associated with a reduction in the odds of being a current smoker of 7% (OR=0.925; 95% CI: 0.918--0.932, p<0.001). For bidis, the association between the retail price and current smoking status was not statistically significant (OR=1.01; 95% CI: 1.00--1.02, p=0.082). CONCLUSIONS Current increases in the retail prices of tobacco products in India seem to have an impact on the use of cigarettes but not bidis. This highlights the need for tobacco product tax increases that result in sufficient retail prices increase to make all tobacco products less affordable and reduce their use. [ABSTRACT FROM AUTHOR]

Introduction: In September 2014, the Government of India introduced legislation requiring all tobacco packaging to display a health warning covering 85% (60% pictorial, 25% text) of the principal display area of the pack, of at least 4 cm in height and 3.5 cm width, with legible text in a white font on a black background and in English and/or the same Indian language as the language used on the pack. We evaluated compliance with this legislation in the Udupi district of Karnataka, India.Methods: We procured one example of every tobacco pack of cigarettes, beedis, chewing tobacco, and snuff sold by a convenience sample of retailers in one urban and two rural areas in each of the five administrative blocks of the Udupi district between June and August 2018. For each pack we measured the size of the health warning, calculated the proportion of the pack covered, and assessed the legibility.Results: A total of 365 packs were collected from retailers, with 357 of these branded and eight, all packs of snuff, unbranded. Warnings on 320 (87.3%) packs did not reach the legally required proportional magnitude, warnings on 140 (38.4%) packs were not legible, and warnings on 117 packs (32.1%) did not meet the language requirement. Only 45 packs (12.3%) were fully compliant.Conclusions: Compliance with warning legislation in this district of India is low, highlighting the need for more effective enforcement.Implications: Warnings on tobacco packaging are an important and inexpensive means of communicating the harms associated with tobacco use. However, relatively few studies have explored regulatory compliance with warnings. We collected all unique tobacco packs from 66 retailers in a district in Karnataka in India and assessed whether each met the legislative requirements in terms of warning size and proportion of the pack covered, legibility, and the language used. Of the 365 packs collected, only one in eight was compliant with the legislative requirements. This study highlights the importance of assessing warning compliance and the need for enforcement in India. [ABSTRACT FROM AUTHOR]

Background: Beedi rolling is one of the principal occupations of women residing in coastal Karnataka. The beedi worker's welfare fund consists of a combination of schemes to improve the living conditions of beedi workers and their families. On the other hand, the government is introducing several anti-tobacco policies, which could lead to insecurity among beedi rollers about their future. As a result, majority of the trade unions believe that alternate livelihood must be provided to the workers. In the midst of economic benefits and stringent tobacco control policies, this study explores the perception of beedi rollers to quit tobacco rolling and engage with an alternative livelihood. Objectives: The objectives of this study were as follows: (1) to explore the opinion of beedi workers toward alternate means of livelihood and (2) to identify the benefits availed by the beedi workers. Methodology: The study was conducted with a semi-structured questionnaire by interview method in all the seven blocks of the Udupi district of Karnataka with a total of 381 respondents through convenience sampling. The interviewer administered the survey with the help of a predesigned user application which was developed through Kobo Toolbox, and the analysis was carried out using IBM SPSS version 26. Results: Although 69% of the respondents believed that beedi rolling is not a secured job, three-fourth of the respondents were not ready to quit the beedi rolling job due to low education, higher age, and lack of financial support to invest in other occupations. Conclusion: Our study showed that most of the participants were full-time beedi rollers and most of them were not ready to shift to other jobs due to old age, lack of experience with other vocations, and benefits availed. There is a need to focus on strengthening skill development programs and introduce sustainable economic alternatives to the beedi rollers. [ABSTRACT FROM AUTHOR]

Background: The Government of Karnataka banned loose cigarettes sale effect from September 2017 and is punishable under Cigarettes and Other Tobacco Products Act (COTPA) with fine and imprisonment in case of violation. Aim & Objective: Study aims to assess awareness, perceptions and practices about ban among tobacco vendors and smokers. Methods and Material: Cross sectional survey was carried using pre-tested questionnaire to collect information regarding awareness about ban among vendors and smokers. Data were analyzed using SPSS version 15.0. Results: Ninety-five percent of the tobacco vendors continued to sell loose cigarettes despite the ban. Among vendors, 49.7%, were aware of ban and of them 53.5% knew it is a punishable offense. Vendors opined that they would stop selling loose cigarettes if ban is strictly enforced with frequent checks on periodical basis. One-fourth smokers opined they will reduce cigarettes consumption with few making an attempt to quit. Conclusions: Awareness about ban on sale of loose cigarettes was unsatisfactory among vendors and smokers including lack of knowledge regarding legal actions in case of violation. However, vendors responded favorably towards obeying the law. Smokers are likely to reduce or even quit smoking if the law is strictly enforced which highlights the need for creating awareness drives and strong enforcement of the policy. [ABSTRACT FROM AUTHOR]

INTRODUCTION The Government of India has taken several steps to reduce tobacco use, including legislation in the Cigarettes and Other Tobacco Products Act (COTPA) requiring health warnings on tobacco products. This study assessed compliance with the legislation on warnings, and awareness of these warnings and their perceived impact in preventing tobacco uptake among college students in a district of Karnataka, India. METHODS This study consisted of two components, pack collection and a survey. For the first, tobacco packs were obtained from all tobacco selling shops in an urban and a rural locality in the Karkala block of Udupi district. Empty cigarette packs were collected from shops, and full packs were purchased if empty packs were not available . The packs were collected to measure their dimensions, as per the Tobacco Pack Surveillance System guidelines, and assessed for compliance, as per COTPA. For the second component of the study, a questionnaire was distributed to each college student to fill in; this was done to assess awareness of the new warnings at the time of the pilot survey, knowledge of harms, and perceptions of the warnings in reducing tobacco uptake. RESULTS We collected 26 tobacco packs. Two (8%) packs had warnings that were the correct size (85% of the main display areas), 15 (58%) packs had clear and legible warnings, and 18 (69%) packs had warning messages in the appropriate language. In the student survey, 60% of males and 52% of females indicated that they would not start using any tobacco products on seeing the new warnings. CONCLUSIONS Only a few studies other than our pilot study have assessed compliance with legislation on health warnings in low- or middle-income countries. Although health warnings were perceived as a deterrent to tobacco use among students, compliance with national legislation in this pilot study was found to be low. [ABSTRACT FROM AUTHOR]

Introduction: Children are the foundation of a strong and healthy nation. Morbidity among school-going children adversely affects their normal growth and development and hence is a major public health concern. School health program was started as an important component of total health care delivery system in the country with a purpose of addressing the health needs of children. Aim: To assess the morbidity pattern and nutritional status among school children. Materials and Methods: Study design: A cross-sectional study. Study period: 1-year from 1st July 2012 to 30th June 2013. Study setting: 14 schools with a total strength of 909 children in a rural area of coastal Karnataka. Data collection: Health examination of the school children was carried out by a trained team. Data regarding anthropometric measurements, refractory error, medical problems and minor ailments were collected using a predesigned proforma. Results: A total of 797 children were examined. Dental caries was the most common ailment observed in 31.86% of children 43.32% of the children were underweight, 53.03% were normal, and 3.65% were overweight for age. Conclusion: The school health program provides a good opportunity to screen, identify and impart education regarding health related issues. The common morbidities found were dental caries, pallor, upper respiratory tract infection and refractory error. Overweight was also observed in the school children and needs to be addressed. There is a scope of providing comprehensive school health services by incorporating dental care. [ABSTRACT FROM AUTHOR]