Dental practitioners self reported performance of tobacco cessation counselling interventions – A cross sectional study

Introduction and Rationale The objective of the study was to determine the knowledge, attitude and behaviors of the practicing dentists regarding Tobacco Cessation Counseling (TCC) in Chhattisgarh state and also the barriers that prevents them from doing so. Methods: The study was conducted among the dental practitioners of Raipur district, Chhattisgarh state (India). The sampling frame comprised of the dental practitioners registered with the State Dental Council and practicing in Raipur district. The questionnaire was personally administered and the practitioners were explained regarding how to complete the questionnaire. Only descriptive statistics were calculated (SPSS version 16 for Windows). Results: Based on the responding dentists’ self reports, 76% were not confident in TCC, 48% did not assume TCC as their responsibility, 17% considered that it might have a negative impact on their clinical practice whereas 24% considered it might take away precious time from their practice, 25% considered TCC by dentists to be effective to a considerable extent and 80% considered TCC activities are not effective due to lack of formal training, 69% considered dental clinics as an appropriate place for TCC but 82% thought there must be separate TCC centre and 100% of the dentists wanted TCC training to be a part of practice and that it should be included in dental curriculum. 95% of them were of the view that tobacco products should be banned in India and 86% responded that health professionals must refrain from tobacco habits so to act as role models for the society. Conclusion: to include strategies The institutions should the and the dental professionals at the and the community health care be in to treat tobacco dependence. Abstract Tobacco use is associated with a variety of oral precancerous lesions such as cancer, leukoplakia, erythroplakia etc. The lesions caused by smokeless tobacco can be reversed by quitting the habit at an earlier stage and providing appropriate treatment. Thus, proving the importance of early diagnosis in prevention of debilitating diseases caused by tobacco use. Objective This study was conducted to assess the prevalence of oral mucosal lesions and tobacco consumption patterns among industrial workers of Belgaum city, Karnataka. Materials and methods: This was a descriptive cross-sectional study, 1500 industrial workers who met the inclusion and exclusion criteria were included in the study. Permissions were obtained from the industrial division of Belgaum and from heads of each industry. Ethical approval was obtained and informed consent was obtained from the subjects. Tobacco related habits and oral mucosal lesions were recorded using WHO proforma for recording Oral Mucosal diseases. Results: The mean age of the study group was 32.14+9.86 years. Tobacco usage was prevalent among 70.8% and prevalence of oral mucosal lesions was 30.8%. The odds ratio (OR) for smoking, gutkha chewing, ST (Smokeless Tobacco) and alcohol consumption was 1.08, 1.7, 5.2 and 1.6 respectively. After adjusting for confounding factors, the adjusted OR for smokeless tobacco usage (i.e. ST and gutkha) was 12.1. Conclusion: Smokeless tobacco usage was found to be the strongest risk factor for precancerous and cancerous lesions of oral cavity. It is recommended to conduct regular screening and health education program for the industrial workers. Abstract Introduction and Rationale It has been observed that if physicians do not engage in healthy behaviours, they are less likely to encourage such behaviours in their patients and patients are less likely to listen to them even if they do talk about it. This cross sectional study to examine the change in smoking related behaviour of medical students over their stay in medical colleges was carried in the state of Karnataka in India. Methodology: This is a part of ICMR funded project wide IRIS Cell No. 2011-16210 dated 28/12/2011. One government and four private medical colleges were selected from 41 medical colleges in Karnataka using stratified random sampling technique. All of the students who were present and consented were included in the study. Sample size was 4083 and response rate was 80.52%. Information was sought on the status of medical students regarding smoking, at present and before joining the medical college. A pre-tested self-administered multiple choice type questionnaire was used to collect data. SPSS version 10.0 was used to analyze the data. The statistical methods used included Frequencies, proportions and chi-square test. Results: was almost The impact on the changes in the smoking related health promoting/risking behaviour of the medical students after joining the medical college was statistically non-significant. Smoking behaviour of the supplementary/irregular batches students were more health risking as compared to the students of regular batches (p<0.02). The duration of stay in the medical college had a statistically significant (<p0.000) affect on the smoking and the increase of 1.0 percentile points in the number of smokers during 1 st one year reached up to an increase of 23.1 percentile points by the time they were pursuing their internship. Smoking among medical students increases along with their stay in medical college. There is an urgent need to develop support strategies to put an organized effort to inculcate the smoking related health promoting behaviour among those entering as well, already in the profession. Abstract Introduction and Rationale The aim of the study is to know the association of alcohol and tobacco intake in the form of smoking and chewing with gastric carcinoma in West Bengal. Materials and methods: Total 23851 patients (smokers and tobacco chewer 13932, nonsmokers 9919, Alcoholic 9933, Nonalcoholic 13918) were interviewed before endoscopy. Among smokers and tobacco chewers, isolated bidi and cigarette smokers were 3720 and 7973 respectively, whereas wine and liquor intakers 6900 and beer and other beverages intakers 3033. Among 462 gastric cancer cases, smokers were 420 (241 cigarette and 179 bidi smokers) and tobacco chewers 42 respectively. Among alcoholics, wine and liquor intakers were 240 and other beverage intakers’ 53.Then comparison were done: 1. to know the incidence of smokers and nonsmokers, alcoholics and non alcoholics in total number of patients, 2] the influence of smoking and alcohol intake on gastric carcinoma, 3] the number of cigarettes and pegs of alcohol per day on gastric carcinogenesis. Again, comparisons were done to know 1] influence of different types of alcoholic beverages on gastric carcinoma, 2] influence of bidi and cigarettes on gastric carcinoma. Results: Alcoholics, Bidi smokers and wine and liquor intakers earlier starters of smoking and alcoholic beverages gastric Heavy Abstract Introduction and Rationale In terms of health care delivery, Interstate Migrant workers form a marginalized community in Kerala .The health system involvement of the state often gets limited to screening for communicable diseases. Their health status and health related behaviors may be different from the natives and needs to be explored. Objective: To study the prevalence of tobacco use and oral mucosal lesion associated with the use among the male migrant workers in Kannur District Materials and methods: A cross sectional study was carried out among male migrant workers above 18 years working in different factories in Azhikode Panchayat in Kannur district. Total of 244 participants were selected and were assessed for the use of tobacco, type, frequency and duration of use by questionnaire. The trained dental interns conducted oral cavity examination for detecting oral mucosal lesions associated with tobacco use and positive participants were referred to tertiary care hospitals. Result: The prevalence of current usage of smoked and smokeless tobacco were 41.8% and 71.7% respectively. The daily use (including heavy use) was seen in 77.4% of smokers and 86.7% of smokeless tobacco users. More than 90% of smokers used cigarettes. The common smokeless tobacco products used were the tobacco leaves (36.5%),pan masala(28.7%) and khaini (28.6%). Oral mucosal lesions (white lesions, red lesions and ulcers) was seen in 26.2% of participants and 33.7% of smokeless tobacco users (OR:14.7,95%CI 3.5-62.4). Conclusion: Abstract Introduction and Rationale Tobacco is generally perceived as an adult problem yet tobacco use most often starts in youth, vast majority consuming tobacco before the age of 25 years. Oral healths being an important aspect of community health, people are unaware about the hazards of tobacco consumption on oral health. It is important to determine the existing knowledge of people regarding tobacco consumption and its hazards so as to plan needed community interventions to protect people from hazards of tobacco consumption Objective: To determine the knowledge of tobacco consumers on hazards of tobacco consumption on oral health To compare the knowledge of tobacco smokers and tobacco chewers regarding hazards of tobacco consumption on oral health. A descriptive study was conducted at selected communities of Mangalore. A total of 100 tobacco consumers {50 smokers, 50 chewers} were selected by purposive sampling technique. The knowledge of the sample was assessed using structured interview schedule Results Most of the subjects (53%) had good knowledge on oral health hazards. Area wise results showed that tobacco smokers (62.4%) and tobacco chewers (61.3%) had good knowledge in the area of effects of tobacco on oral health. In the area of oral hygienic practices78% of tobacco smokers and 96% of tobacco chewers had very good knowledge. Results of unpaired ‘t’ test showed that there was no significance difference between the knowledge score of tobacco smokers and tobacco chewers since the calculated value ( t 98 = 0.7, p> 0.05). Conclusion The findings of the study support the need for conducting educational programme to increase the knowledge of adults on tobacco consumption and its related problems. Abstract Tobacco is a major preventable of worldwide with more of to it. Tobacco kills nearly 6 million people and billions of dollars of economic each year, most of these in low and middle income countries Objective: To assess the magnitude of tobacco use and associated factors among adults in rural VDCs of Dhankuta district of Eastern Nepal Pre-tested questionnaire adapted from Global Adult Tobacco Survey was used to explore the burden of tobacco use and its associated factors among 271 adults in different VDCs of Dhankuta district during April 2012 to May 2012 by face to face interview using simple random sampling. Bi-variate and multivariate techniques were used for data analysis. were significantly associated with tobacco use after multivariate analysis. The burden of tobacco use is high despite the belief that tobacco use is injurious to health and awareness regarding existence of anti-tobacco law in the country. Abstract Introduction and Rationale Smoking is a problem with worldwide dimension. Health professionals, including medical students, should ideally play an important role in the fight against tobacco use .But several reports suggest that a good number of medical students are themselves addicted to tobacco. This study is being undertaken to see the current situation as no recent study is available for South India. Objective: To study the prevalence, knowledge, attitude and practice of tobacco smoking among students of a Medical College in Central Kerala Materials and methods: A cross –sectional study was done among the medical students of a private college in Central Kerala using a pre – tested questionnaire which had questions regarding the knowledge, attitude and practice of tobacco smoking among medical students. Results: Among the 342 students participated, 26 (7.6%) were found to be current smokers, 72(21.1%) had smoked even a single puff. Three hundred and eight (90.1%) students lived on-campus, of which 25 (8.1%) were smokers. While 34 (9.9%) lived off-campus; of which 1 (2.9%) smokers. Among current smokers, 12 (46.2%) had parental history of smoking and those without parental history had a prevalence rate of 53.8% (14). Study also found that out of the 342 responders in the survey 7(2.04%) students want to start smoking. Conclusion: It is to bring positive behavioral changes through of comprehensive education in medical universities. Compared to previous studies that show smoking percentage of 33% our study indicates a lot of improvement in Kerala. Parents also need to counsel and coach their sons at the time of admission to medical college about dangers of smoking as well as the role of peer pressure in them when they are living in the hostel. Abstract Introduction and Rationale The health consequences of smoking are twofold. First the smoker becomes dependent to nicotine. Second smoking causes fatal and disabling diseases like cancers of lung and other organs, ischemic heart disease, respiratory diseases and the like. Action on Smoking and Health (1999) denoted that smokers are not fully aware of the high health risks of smoking. The investigator during her encounter in community felt that smokers are not aware of its health hazards and thus it was determined to systematically assess whether they were aware of health hazards of smoking with the intention of educating the smoking community regarding health hazards of smoking. Objectives: To Materials Sixty male smokers were selected conveniently and the structured questionnaire formulated by the investigator was administered to them and their awareness regarding health hazards of smoking was assessed and then community based teaching programme was planned and implemented. The whole study was done by descriptive design. Results: Mean percentage knowledge score in causes of smoking is 43.88%, in hazardous effects of smoking is 87.94% and in prevention of smoking is 84.16%.There are significant associations between knowledge level and socio-demographic variables like age of smoker, educational status of smoker, marital status of smoker, monthly income of smoker, number of cigarettes smoked per day and age of start of smoking Conclusion: Health care personnel should take the responsibility of educating the public on smoking and its hazardous effects. Abstract Introduction and Rationale The socio-demographic predictors of alchohol and tobacco chewing are poorly understood especially in tribal areas and that too among retired Govt employees. Estimation of prevalence as well as their associations with specific risk factors is essential for the predicting the future burden of lifestyle diseases including Cancers, cardiovascular, cerebrovascular diseases etc as well as to undertake preventive measures particularly in tribal regions of Jharkhand where there is hardly any data. Objectives: To estimate the prevalence and the socioeconomic and demographic correlates of alcohol consumption. (2) To assess the prevalence of obesity, diabetes, hypertension and Cardio-vascular diseases and to co-relate risk factors associated if any, among retired government employees and their dependents above 35 years of age residing in tribal district of Jharkhand state. Methods: A cross-sectional study was carried out in the month of April 2013 were in data was collected by using pre-tested questionnaire during a screening camp which was organized in a tribal district of Jharkhand. A total of 291 people participated in the study. Results: 97.9 % non-vegeterian. were out of which 13.7 19.2 % Abstract Introduction and Rationale Kerala Government by its order No: A/1327/2012/CFS dated on 22nd May 2012 banned the sale of Gudka and Panmasala in which Tobacco and Panmasala are used as ingredients in the State. In the wake of the enforcement drive to implement the State government’s ban on the sale of pan masala, a study has disputed the argument raised by tobacco companies that the ban will lead to large scale loss in revenue and employment especially among small scale traders in the State. To find out the ban in tobacco products affected the prospects of small scale vendors or not. Materials and Methods: The study was based on a sample survey covering 1,200 shops in Kottayam, Changanacherry, Pala, Kanjirapally, Karukachal, Vaikom, Ettumanoor, Kaduthuruthy, Chingavanam, Kumarakom and Puthupally. A questionnaire was prepared and by interview, the questionnaire was filled up. Results: bakery items to compensate for the slight fall in revenue. Abstract Introduction and Rationale Many studies and reports on alcoholism reveals that alcoholism is getting famous among adolescent because of the culture of the country, peer influences, family influences etc. Many death and accidents are been caused due to alcoholism among the adolescents. Objectives: To assess the knowledge and attitude of adolescents regarding alcoholism and to create awareness among adolescents about alcoholism. Methods & Materials: This study was a descriptive and conducted the selected college of Pokhara, Nepal. The tools were Demographic Performa, Knowledge Questionnaire, Attitude Scale and Informative Sheets on Alcoholism. Data were collected by self administering the structured questionnaire to the college students among 100 samples. The data was analyzed using statistical and inferential statistics and Microsoft Excel 2007, SPSS 16.0 was used for easy data analysis. Results: Majority of the adolescents were having average knowledge i.e.60% and 58% of the adolescents were having moderately favorable attitude. There was no significant association between demographic variable and knowledge .Where there was significant association of sex and type of family with attitude (p=<0.005) and there was no significant association with other demographic variables and attitude. There was positive correlation between knowledge and attitude (p<0.99). Conclusion: The findings of the study revealed that there was average knowledge and moderately favorable attitude but still there is need of awareness programs for the prevention of adolescents from ill effects of alcoholism to improve the knowledge and attitude towards alcoholism among adolescents. Hence there is need of the awareness programs among adolescents and it can be given not only through the family but also from the educational institutions, mass media, cultural practices etc. Abstract Introduction and Rationale Non-alcoholic fatty liver disease is a disorder recently identified as a major health concern in developed countries. It may be prevented from complications with life style modifications. Studies on this topic are limited and hence the current study is undertaken. Objectives: To study in clinic-epidemiological profile of NAFLD patients. Materials and Methods: The study was a hospital based observational study including 377 fatty liver patients. Patients were selected based on clinical or imaging finding. The study period was one and half years. Results: Most of the affected people were young with male to female ratio 1.1:1. Diabetes, hypertension, dyslipidemia, coronary heart disease were noticed among 80.7%, 78.9%, 77.2% and 29.8%.. 71.9% of the study population was sedentary and majority with obesity. Stigmata of hyperlipidemia noticed in 60.2%, insulin resistance noticed in 44.3% and signs of atherosclerosis were seen in 31.6% of the study population. 54.7% were anemic. Ferritin was raised in 251 patients(66.58%). Dyslipidemia was noticed in 72% Ultrasonogram revealed mild fatty changes in 166 (44%) and moderate fatty changes in 211 (56%). The more the age, more was the fibrosis changes detected in 01). There was significant association between ultrasound findings and co morbidities Conclusions: and were having significant truncal obesity. There was significant association between fatty liver and ferritin values, increasing age and ultrasound finding.


Introduction and Rationale
The objective of the study was to determine the knowledge, attitude and behaviors of the practicing dentists regarding Tobacco Cessation Counseling (TCC) in Chhattisgarh state and also the barriers that prevents them from doing so.

Methods:
The study was conducted among the dental practitioners of Raipur district, Chhattisgarh state (India). The sampling frame comprised of the dental practitioners registered with the State Dental Council and practicing in Raipur district. The questionnaire was personally administered and the practitioners were explained regarding how to complete the questionnaire. Only descriptive statistics were calculated (SPSS version 16 for Windows).

Results:
Based on the responding dentists' self reports, 76% were not confident in TCC, 48% did not assume TCC as their responsibility, 17% considered that it might have a negative impact on their clinical practice whereas 24% considered it might take away precious time from their practice, 25% considered TCC by dentists to be effective to a considerable extent and 80% considered TCC activities are not effective due to lack of formal training, 69% considered dental clinics as an appropriate place for TCC but 82% thought there must be separate TCC centre and 100% of the dentists wanted TCC training to be a part of practice and that it should be included in dental curriculum. 95% of them were of the view that tobacco products should be banned in India and 86% responded that health professionals must refrain from tobacco habits so to act as role models for the society.

Conclusion:
Dental professionals must expand their armamentarium to include TCC strategies in their clinical practice. The dental institutions should include TCC in to the curriculum and the dental professionals at the primary and the community health care level should also be trained in TCC to treat tobacco dependence.

Introduction and Rationale
It has been observed that if physicians do not engage in healthy behaviours, they are less likely to encourage such behaviours in their patients and patients are less likely to listen to them even if they do talk about it. This cross sectional study to examine the change in smoking related behaviour of medical students over their stay in medical colleges was carried in the state of Karnataka in India.

Methodology:
This is a part of ICMR funded project wide IRIS Cell No. 2011-16210 dated 28/12/2011. One government and four private medical colleges were selected from 41 medical colleges in Karnataka using stratified random sampling technique. All of the students who were present and consented were included in the study. Sample size was 4083 and response rate was 80.52%. Information was sought on the status of medical students regarding smoking, at present and before joining the medical college. A pre-tested self-administered multiple choice type questionnaire was used to collect data. SPSS version 10.0 was used to analyze the data. The statistical methods used included Frequencies, proportions and chi-square test.

Results:
Sample size was 4083 and response rate was 80.52%. It was observed that the number of smokers among medical students after joining medical college had increased almost by 2.7 times (p <0.001), males (2.4 times) and females (4.2 times). College-wise increase in the number of smokers varied between 2.3 times to 3.6 times (p <0.001). The impact of Religion, caste, place of residence (urban/rural) and management of college (government/private) on the changes in the smoking related health promoting/risking behaviour of the medical students after joining the medical college was statistically non-significant. Smoking behaviour of the supplementary/irregular batches students were more health risking as compared to the students of regular batches (p<0.02). The duration of stay in the medical college had a statistically significant (<p0.000) affect on the smoking and the increase of 1.0 percentile points in the number of smokers during 1 st one year reached up to an increase of 23.1 percentile points by the time they were pursuing their internship.

Conclusion:
Smoking among medical students increases along with their stay in medical college. There is an urgent need to develop support strategies to put an organized effort to inculcate the smoking related health promoting behaviour among those entering as well, already in the profession.

Abstract Introduction and Rationale
The aim of the study is to know the association of alcohol and tobacco intake in the form of smoking and chewing with gastric carcinoma in West Bengal.

Materials and methods:
Total 23851 patients (smokers and tobacco chewer 13932, nonsmokers 9919, Alcoholic 9933, Nonalcoholic 13918) were interviewed before endoscopy. Among smokers and tobacco chewers, isolated bidi and cigarette smokers were 3720 and 7973 respectively, whereas wine and liquor intakers 6900 and beer and other beverages intakers 3033. Among 462 gastric cancer cases, smokers were 420 (241 cigarette and 179 bidi smokers) and tobacco chewers 42 respectively. Among alcoholics, wine and liquor intakers were 240 and other beverage intakers' 53.Then comparison were done: 1. to know the incidence of smokers and nonsmokers, alcoholics and non alcoholics in total number of patients, 2] the influence of smoking and alcohol intake on gastric carcinoma, 3] the number of cigarettes and pegs of alcohol per day on gastric carcinogenesis. Again, comparisons were done to know 1] influence of different types of alcoholic beverages on gastric carcinoma, 2] influence of bidi and cigarettes on gastric carcinoma.

Results:
Alcoholics, Bidi smokers and wine and liquor intakers earlier starters of smoking and alcoholic beverages significantly (P<0.0001) suffered from gastric carcinoma. Heavy drinkers and smokers were mostly affected (P<0.0001).

Conclusions:
Bidi smokers and wine and liquor drinkers, young heavy smokers and drinkers were mostly affected. So there were strong associations between bidi smoking, wine and liquor intakers and gastric carcinoma in West Bengal.

Introduction and Rationale
In terms of health care delivery, Interstate Migrant workers form a marginalized community in Kerala .The health system involvement of the state often gets limited to screening for communicable diseases. Their health status and health related behaviors may be different from the natives and needs to be explored.

Objective:
To study the prevalence of tobacco use and oral mucosal lesion associated with the use among the male migrant workers in Kannur District

Materials and methods:
A cross sectional study was carried out among male migrant workers above 18 years working in different factories in Azhikode Panchayat in Kannur district. Total of 244 participants were selected and were assessed for the use of tobacco, type, frequency and duration of use by questionnaire. The trained dental interns conducted oral cavity examination for detecting oral mucosal lesions associated with tobacco use and positive participants were referred to tertiary care hospitals.

Result:
The prevalence of current usage of smoked and smokeless tobacco were 41.8% and 71.7% respectively. The daily use (including heavy use) was seen in 77.4% of smokers and 86.7% of smokeless tobacco users. More than 90% of smokers used cigarettes. The common smokeless tobacco products used were the tobacco leaves (36.5%),pan masala(28.7%) and khaini (28.6%). Oral mucosal lesions (white lesions, red lesions and ulcers) was seen in 26.2% of participants and 33.7% of smokeless tobacco users (OR:14.7,95%CI 3.5-62.4).

Conclusion:
Despite the ban on sale of tobacco products in the state, current use of smokeless tobacco is highly prevalent among migrant workers. Screening camps organized for migrant workers should also include a component for oral cancer detection.

Introduction and Rationale
Tobacco is generally perceived as an adult problem yet tobacco use most often starts in youth, vast majority consuming tobacco before the age of 25 years. Oral healths being an important aspect of community health, people are unaware about the hazards of tobacco consumption on oral health. It is important to determine the existing knowledge of people regarding tobacco consumption and its hazards so as to plan needed community interventions to protect people from hazards of tobacco consumption

Objective:
To determine the knowledge of tobacco consumers on hazards of tobacco consumption on oral health To compare the knowledge of tobacco smokers and tobacco chewers regarding hazards of tobacco consumption on oral health.

Materials and Methods
A descriptive study was conducted at selected communities of Mangalore. A total of 100 tobacco consumers {50 smokers, 50 chewers} were selected by purposive sampling technique. The knowledge of the sample was assessed using structured interview schedule

Results
Most of the subjects (53%) had good knowledge on oral health hazards. Area wise results showed that tobacco smokers (62.4%) and tobacco chewers (61.3%) had good knowledge in the area of effects of tobacco on oral health. In the area of oral hygienic practices78% of tobacco smokers and 96% of tobacco chewers had very good knowledge. Results of unpaired 't' test showed that there was no significance difference between the knowledge score of tobacco smokers and tobacco chewers since the calculated value ( t 98 = 0.7, p> 0.05).

Conclusion
The findings of the study support the need for conducting educational programme to increase the knowledge of adults on tobacco consumption and its related problems.

Abstract Introduction and Rationale
Tobacco use is a major preventable cause of death worldwide with more than 4% global burden of disease is attributed to it. Tobacco kills nearly 6 million people and causes billions of dollars of economic damage each year, most of these deaths occur in low and middle income countries

Objective:
To assess the magnitude of tobacco use and associated factors among adults in rural VDCs of Dhankuta district of Eastern Nepal

Materials and Methods
Pre-tested questionnaire adapted from Global Adult Tobacco Survey was used to explore the burden of tobacco use and its associated factors among 271 adults in different VDCs of Dhankuta district during April 2012 to May 2012 by face to face interview using simple random sampling. Bivariate and multivariate techniques were used for data analysis.

Results
Prevalence of tobacco use was 49.81% (Male 59% and female 41%). Among the total participants, 35.4% were currently using some form of tobacco. Majority of the users consumed tobacco at home (58%) whereas 33% used it in public places. Majority of the users consumed tobacco in front of family members (85%). Among the participants, 91% believed that tobacco use is injurious to health and more than half (58%) were aware of anti-tobacco law in Nepal. Male gender (AOR=3.43, 95%CI 1.90 to 6.19), being illiterate (AOR=2.17, 95% CI 1.15 to 4.13) and being widow/widower/separated/divorced (AOR=6.25, 95%CI 1.92 to 20.37) were significantly associated with tobacco use after multivariate analysis.

Introduction and Rationale
Smoking is a problem with worldwide dimension. Health professionals, including medical students, should ideally play an important role in the fight against tobacco use .But several reports suggest that a good number of medical students are themselves addicted to tobacco. This study is being undertaken to see the current situation as no recent study is available for South India.

Objective:
To study the prevalence, knowledge, attitude and practice of tobacco smoking among students of a Medical College in Central Kerala

Materials and methods:
A cross -sectional study was done among the medical students of a private college in Central Kerala using a pretested questionnaire which had questions regarding the knowledge, attitude and practice of tobacco smoking among medical students.

Results:
Among the 342 students participated, 26 (7.6%) were found to be current smokers, 72(21.1%) had smoked even a single puff. Three hundred and eight (90.1%) students lived oncampus, of which 25 (8.1%) were smokers. While 34 (9.9%) lived off-campus; of which 1 (2.9%) smokers. Among current smokers, 12 (46.2%) had parental history of smoking and those without parental history had a prevalence rate of 53.8% (14). Study also found that out of the 342 responders in the survey 7(2.04%) students want to start smoking.

Conclusion:
It is necessary to bring positive behavioral changes through adoption of comprehensive smoking control interventions, counseling methods and health education in medical universities. Compared to previous studies that show smoking percentage of 33% our study indicates a lot of improvement in Kerala. Parents also need to counsel and coach their sons at the time of admission to medical college about dangers of smoking as well as the role of peer pressure in them when they are living in the hostel.

Introduction and Rationale
The health consequences of smoking are twofold. First the smoker becomes dependent to nicotine. Second smoking causes fatal and disabling diseases like cancers of lung and other organs, ischemic heart disease, respiratory diseases and the like. Action on Smoking and Health (1999) denoted that smokers are not fully aware of the high health risks of smoking. The investigator during her encounter in community felt that smokers are not aware of its health hazards and thus it was determined to systematically assess whether they were aware of health hazards of smoking with the intention of educating the smoking community regarding health hazards of smoking.

Objectives:
To assess awareness of smokers regarding smoking and its hazardous effects.
To determine association between level of awareness of smokers regarding smoking and its hazardous effects with selected socio-demographic factors.

Materials and Methods:
Sixty male smokers were selected conveniently and the structured questionnaire formulated by the investigator was administered to them and their awareness regarding health hazards of smoking was assessed and then community based teaching programme was planned and implemented. The whole study was done by descriptive design.

Results:
Mean percentage knowledge score in causes of smoking is 43.88%, in hazardous effects of smoking is 87.94% and in prevention of smoking is 84.16%.There are significant associations between knowledge level and sociodemographic variables like age of smoker, educational status of smoker, marital status of smoker, monthly income of smoker, number of cigarettes smoked per day and age of start of smoking

Introduction and Rationale
The socio-demographic predictors of alchohol and tobacco chewing are poorly understood especially in tribal areas and that too among retired Govt employees. Estimation of prevalence as well as their associations with specific risk factors is essential for the predicting the future burden of lifestyle diseases including Cancers, cardiovascular, cerebrovascular diseases etc as well as to undertake preventive measures particularly in tribal regions of Jharkhand where there is hardly any data.

Objectives:
To estimate the prevalence and the socioeconomic and demographic correlates of alcohol consumption. (2) To assess the prevalence of obesity, diabetes, hypertension and Cardio-vascular diseases and to co-relate risk factors associated if any, among retired government employees and their dependents above 35 years of age residing in tribal district of Jharkhand state.

Methods:
A cross-sectional study was carried out in the month of April 2013 were in data was collected by using pre-tested questionnaire during a screening camp which was organized in a tribal district of Jharkhand. A total of 291 people participated in the study.

Results:
The mean age of the study participants was 54.24 +/-5.43. 58.4 % were from rural areas while 41.6 % were from urban. 55 % received pension between 5000-10,000 and 12.4% received pension between 10,001 -20,000 while 26.5% didn't respond. 41.9 % were practicing farming during post retirement life and 97.9 % were non-vegeterian. 33% were alcoholic out of which 13.7 % were current user and 19.2 % were past user while 67 % were non-alcoholic. 21.6% had rum , 3.2% had local made like Mava/Hadia and 1% had whisky.4.5% use to drink alchohol daily, 12 % once/twice weekly and 5.1% use to drink thrice weekly. 15.1% drank alchohol for more than 20 years while 12.4% for 10-20 years and 0.7% drank for less than 5 years. Occupation and income had positive impact on alchohol intake. The prevalence of hypertension was 13% (39). 9% had frank Diabetes mellitus (DM) and 25% had Pre-DM condition. 7.2 % were obese and 26.1% were pre-obese. 33% and 11% of pre-obese and obese persons were alcohol users while 22 % of Hypertensive were alcohol users. 33% and 13% of prediabetic and diabetic were alcohol users.

Conclusion:
Although the prevalence of alcohol use and lifestyle diseases was high but lower in comparison to other parts of the country in-spite of increased risk factors. Various factors like availability, Cost, individual preference, peer group influence, lifestyle pattern and local environmental factors may play an important role which needs to be studied in detail. There is a need for periodical surveys using more consistent definitions of alcohol use and eliciting information on factors favoring alcohol intake carried out at multiple areas among representative samples.

Introduction and Rationale
Kerala Government by its order No: A/1327/2012/CFS dated on 22nd May 2012 banned the sale of Gudka and Panmasala in which Tobacco and Panmasala are used as ingredients in the State. In the wake of the enforcement drive to implement the State government's ban on the sale of pan masala, a study has disputed the argument raised by tobacco companies that the ban will lead to large scale loss in revenue and employment especially among small scale traders in the State.

Objectives:
To find out the ban in tobacco products affected the prospects of small scale vendors or not.
A questionnaire was prepared and by interview, the questionnaire was filled up.

Results:
The sale of tobacco products accounted for only 1% of the total revenue of 55% earned by the traders surveyed. Only 8% of the traders reported between 10% and 30% revenue loss from tobacco products. Majority of them were roadside vendors. Only 4% of the traders exclusively dealt in tobacco products and of this 3% were roadside vendors, mostly migrants. 48% of the traders reported no loss of income owing to the ban.

Conclusion:
There is no substantial loss of revenue of the small scale vendors after the ban in Kerala. . Interestingly, 65% of all the traders surveyed had started sale of other products like banana, vegetables, soft drinks, or bakery items to compensate for the slight fall in revenue.

Corresponding Author
Dr Binoy Surendra Babu Division of Health Management, School of Medical Education MG University,

Introduction and Rationale
Many studies and reports on alcoholism reveals that alcoholism is getting famous among adolescent because of the culture of the country, peer influences, family influences etc. Many death and accidents are been caused due to alcoholism among the adolescents.
Objectives: To assess the knowledge and attitude of adolescents regarding alcoholism and to create awareness among adolescents about alcoholism.

Methods & Materials:
This study was a descriptive and conducted the selected college of Pokhara, Nepal. The tools were Demographic Performa, Knowledge Questionnaire, Attitude Scale and Informative Sheets on Alcoholism. Data were collected by self administering the structured questionnaire to the college students among 100 samples.
The data was analyzed using statistical and inferential statistics and Microsoft Excel 2007, SPSS 16.0 was used for easy data analysis.
Results: Majority of the adolescents were having average knowledge i.e.60% and 58% of the adolescents were having moderately favorable attitude. There was no significant association between demographic variable and knowledge .Where there was significant association of sex and type of family with attitude (p=<0.005) and there was no significant association with other demographic variables and attitude. There was positive correlation between knowledge and attitude (p<0.99).

Conclusion:
The findings of the study revealed that there was average knowledge and moderately favorable attitude but still there is need of awareness programs for the prevention of adolescents from ill effects of alcoholism to improve the knowledge and attitude towards alcoholism among adolescents. Hence there is need of the awareness programs among adolescents and it can be given not only through the family but also from the educational institutions, mass media, cultural practices etc.

Introduction and Rationale
Non-alcoholic fatty liver disease is a disorder recently identified as a major health concern in developed countries. It may be prevented from complications with life style modifications. Studies on this topic are limited and hence the current study is undertaken.

Objectives:
To study in clinic-epidemiological profile of NAFLD patients.

Materials and Methods:
The study was a hospital based observational study including 377 fatty liver patients. Patients were selected based on clinical or imaging finding. The study period was one and half years.

Results:
Most of the affected people were young with male to female ratio 1.1:1. Diabetes, hypertension, dyslipidemia, coronary heart disease were noticed among 80.7%, 78.9%, 77.2% and 29.8%.. 71.9% of the study population was sedentary and majority with obesity. Stigmata of hyperlipidemia noticed in 60.2%, insulin resistance noticed in 44.3% and signs of atherosclerosis were seen in 31.6% of the study population. 54.7% were anemic. Ferritin was raised in 251 patients(66.58%). Dyslipidemia was noticed in 72% Ultrasonogram revealed mild fatty changes in 166 (44%) and moderate fatty changes in 211 (56%). The more the age, more was the fibrosis changes detected in 01). There was significant association between ultrasound findings and co morbidities

Conclusions:
Non alcoholic fatty liver disease is hepatic component of metabolic syndrome. Non alcoholic liver disease is a life style disease with strong association to unhealthy fatty food and sedentary lifestyle. Majority of the patients were obese and were having significant truncal obesity. There was significant association between fatty liver and ferritin values, increasing age and ultrasound finding.