CECHE’s Tobacco-Control Program In South India shows impact

Text Box: Pattur self-help groups use music to engage audiences in tobacco awareness

Six years ago, all 2,500 families in the South Indian village of Pattur supported themselves by rolling beedis, small, unfiltered cigarettes.  Today, only 250 families earn their living this way.  Meanwhile, the number of companies that collect Pattur beedis has dropped from five to three in the last year, and the incidence of beedi smoking in the village is down 60 percent. CECHE, with Chennai-based NGO Roshni, has been conducting a Tobacco Control Communications Program in Pattur, South India.  The program provides vocational training and job placement in non-tobacco trades for families.  It also offers incentives to refrain from tobacco-related activities.

CECHE’s program was launched on September 14, 2004 in partnership with Roshni--an NGO in Chennai, South India. The program is based in Pattur, a village near Chennai, with a population of some 2000 families and whose main source of income derived from rolling tobacco leaves to make beedis for smoking. The village population was heavily engaged in making beedis and had a high prevalence of beedi smoking, even among young children. The primary goal of this project has been to create an awareness of the health hazards of smoking among the village population and to train selected members of the population, especially women, in skills suitable for non-tobacco trades. Roshni and CECHE are jointly supporting this effort.

The Training And Communications Program

The program led to the formation of self help groups, introducing micro credit schemes, non-formal education, vocational training, health and hygiene classes and camps, and income generating skills. The program has been employing both print and electronic media. Principal approaches and activities are outlined below:

  1. With the help of self-help groups, perform street plays, skits, and group songs on health hazards of smoking.
  2. Conduct poster, dramatic and project competitions on the hazards of tobacco.
  3. Print health monitoring cards, and make use of other media and communication technology on tobacco control campaigns.
  4. Set up a clinic and a hygiene centre, conduct medical and health camps that perform periodic follow up.

    Text Box: Health camp at Pattur
  5. Set up a counselling facility in the health centre for conducting counselling sessions among the beedi makers and smokers.
  6. Increasingly engage more groups in the community in tobacco control campaigns.
  7. Enhance vocational training and job searches and placements and wean away people from tobacco rolling.
  8. Arrange nutrition and hygiene sessions with demonstrations on cooking healthy food.
  9. Participate in WHO’s biannual QUIT and WIN campaign.
  10. Adopt science-based methods for treating tobacco dependence.

One of the primary goals of the Tobacco Control Communications Program in S. India was the forma­tion of self-help groups that practice and promote a healthy lifestyle in general and cessation of beedi rolling and smoking in particular. Targeted primarily to women, these groups meet once a week and include voca­tional fieldwork and microcredit discussions, as well as treatment and clinical follow-up for former beedi laborers.

To encourage education, Roshni annually provides scholarships to nearly150 boys and girls from beedi laborers families. Scholarships to school/college students are given if there is no evidence of tobacco consumption or beedi rolling in their families.

The CECHE-Roshni initiative also conducts monthly activities to forward tobacco awareness and change, and organizes health and hygiene classes and camps; the first health workshop took place in Septem­ber 2005 and focused on healthy cooking, clean food and nutritious choices for special-needs groups such as children and diabetics.

The Program annually celebrates World No Tobacco Day. On May 31st, 2006 it celebrated the World No Tobacco Day in collaboration with the Anti-Tobacco Clinic of the Cancer Institute and Tuberculosis Research Center in Chennai. A year round health check up scheme was launched with the assistance of the local primary health center. Local authorities of Pattur village strictly enforce laws against smoking in public places. Breaking these laws is subject to heavy penalty.

In November 2006, a valedictory function featured tobacco control competitions such as quiz programs, oratorical contests and fancy dress competitions were held and prizes were distributed. That same year, nearly 300 villagers participated in prize-filled Roshni-sponsored competitions and oratorical contests.

In 2007, Roshni-CECHE self-help groups comprising 20 women each continued their weekly sessions to train Pattur families in smoking cessation, nutrition, health and hygiene.  Sponsoring regular activities such as health camps, these groups provide valuable vocational training in non-tobacco trades such as tailoring and focus on income-generating skills such as using micro-credit programs. Employing print and electric media to reach its audience and promote its goals throughout 2007, Roshni’s World No Tobacco Day celebrations in May with Chennai-based health institutes attracted hundreds of participants via a mass-media campaign complete with a poster competition and a health-education drive targeting teens.

Program Results And Impact
The project has assessed the impact of the educational and training activities on smoking cessation among beedi smokers as well as on the increase in non-tobacco trades among those originally engaged in rolling tobacco leaves. Descriptive analyses were used to evaluate the project’s external validity and to determine the public’s response to the project activities. The impact of pamphlets and other educational materials on the hazards of smoking were assessed through random interviews and discussions with residents.

Periodic health check ups at the health centre associated with medical and health camps and periodic follow ups have helped to assess the degree of awareness created among the beedi smokers. The number of people who have received anti-smoking counselling and those who have quit smoking were anticipated to increase. This health promotion programme to help people quit smoking and to take up non-smoking trades would have been anticipated to lead to substantial health and economic benefits among the village population. Developing and identifying an effective smoking cessation training activities programme for the people of Pattur was intended to contribute to the reduction of beedi smoking- related morbidity and mortality in South India.

With the two-year program passing its halfway point, progress was already palpable. In June 2005, Pattur resi­dents exhibited a strong knowledge of tobacco hazards when Roshni conducted a prize-filled quiz contest in the village. During the past year, 61 girls who underwent training at Roshni’s tailoring school were awarded two-month apprenticeships at a nearby leather factory and are now earning monthly salaries that are enviable by Indian standards. Similarly, six boys got into workshops and the leather industry after completing a voca­tional course offered through the program. In the last 3 months of 2005, an additional five members from different families in Pattur quit smoking.

In the first year alone, as many as 100 individuals and nine families gave up beedi production for other professions, including garment design, tailoring and em­broidery, leather goods production and grocery/shop businesses.

Furthermore, the Councillor of Pattur has noted the following progress:

  • The decrease in beedi laborers has forced many beedi companies to shut down in the last two years leaving only 3 beedi companies open compared to over 25 a few years ago. Beedi rolling laborers currently are mostly elderly parents and grandparents with most youngsters getting involved in other professions.
  • Roshni through its self- help groups has found jobs for over 300 boys and girls in nearby leather good manufacturing industries.

Overall, over the last two years, from 2005 to 2007, more than 200 individuals and 20 families have left beedi production for garment design, tailoring and embroidery, leather goods production and grocery/shop businesses.  In fact, the rate of beedi production and beedi-rolling in Pattur was reduced by 50 percent in 2006, to 10 percent of what it was five to six years earlier.  The partners have also facilitated enforcement of laws against smoking in public places.

Roshni is a non-profit organization operating in several villages in South India. One of Roshni’s first training centres was established 12 years ago at Pattur. Roshni also conducts tailoring classes at Pattur and enables the women to get diplomas in tailoring and jobs in the garment industry.


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