Authors’ reply to Muthu and Muthanandam

We thank Muthu and Muthanandam[1] for their insightful comments on our article, “Prevalence and risk factors of oral premalignant lesions through visual screening among security personnel working at a tertiary care hospital: A descriptive cross-sectional study.”[2] We agree that such initiatives harbor a challenge in terms of long-term follow-up. However, this has been a niche area of focus for us, and we actively engage with this cohort. We conducted another study[3] from October 2022-February 2023, involving 696 security guards, to examine their tobacco habits and the prevalence of oral potentially malignant disorders. Follow-up in our study[2] was comparatively easier, as the participants were from the same institution, making it simpler to contact or recall them via telephone, unlike heavy vehicle drivers who are frequently on the move. However, the challenge was their changing duty hours. This cohort works 24 × 7, with shifts divided into three time-slots. To address this, we divided participants into groups of fifty and conducted workshops for them. These workshops primarily included yoga trainers for stress management, psychiatry faculty to educate participants on addiction psychology, tobacco cessation techniques, and community medicine faculty to discuss non-communicable diseases. A dental faculty guided on oral cancer and its early identification. The skill enhancement sessions focused on breathing exercises suitable for their workplace, self-oral visual examination, and tobacco cessation methods. Participants were also informed about the hospital’s tobacco cessation facilities and encouraged to avail themselves of these resources. A glimpse of these initiatives is shown in Figure 1.Figure 1: Training sessions of security guardsWe agree with the author’s comment that these vulnerable groups should be targeted through community initiatives.[1] For example, a study in Taiwan used the grounded theory method with purposive sampling to conduct in-depth interviews with male taxi drivers (n = 25) who had successfully quit betel nut chewing for more than 6 months.[4] Similarly, in Bangalore, India, a study of 450 full-time pre-paid cab drivers provided very brief advice (VBA) on tobacco cessation to those who were known tobacco users.[5] Another study conducted in Mumbai, India, involving 400 cab drivers, found that 255 (63.8%) had a history of tobacco use.[6] These individuals were enrolled in a tobacco cessation program, receiving their initial counseling session at the campsite, followed by referrals to a tobacco cessation clinic at a nodal hospital. They were then monitored every 3 months using various tobacco cessation strategies over a one year. The primary approach was behavioral therapy, which included focus group discussions and one-on-one counseling sessions. Follow-up remains a significant challenge. In conclusion, mobile applications and websites offering tobacco cessation support in local languages could serve as a valuable solution to this issue. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.