Feasibility of Volunteer Engagement for Cessation of Tobacco Use among Adults in Urban Bengaluru, India: Qualitative Research Findings to Inform Community-led Tobacco Control Interventions

Introduction: Community-driven interventions involving local volunteers have demonstrated promise for tobacco cessation, but their feasibility and acceptability in low-income settings necessitate further evaluation. This research study aimed to assess the feasibility of volunteer engagement for a community-led intervention of tobacco cessation among adult residents in urban slums of Bengaluru, Karnataka state, India. Methods: An intervention based on Ask, Advise, Assess, Assist, and Arrange Relevance, Risk, Rewards, Roadblocks, and Repetition Model for community volunteers for providing tobacco cessation was developed, along with socio-demographic characteristics and Fagerstrom Tests to be asked to the users, with separate versions for smoking and smokeless tobacco. Qualitative study was undertaken, involving 12 in-depth interviews (6 with counselors, 6 with tobacco-using recipients) to assess feasibility. Transcripts were verbatim transcribed, later translated and back translated, and validated. Interviews were analyzed using thematic analysis using Dedoose software. Results: The counselors and tobacco users were between 22–51 years and 19–50 years, respectively. Major challenges to volunteer engagement included challenges in counseling, reluctance from recipients, geographical constraints, lack of awareness, myths surrounding tobacco, and peer influence. Facilitators encompassed personal growth for volunteers, observed motivation among some users to quit, and support from coordinators. Recipients reported increased knowledge, effective quitting strategies, and perceived benefits such as potential financial savings, suggesting acceptability. Recommendations for improvement included incorporating visual aids, targeting youth, and leveraging community engagement. Conclusions: The research highlights challenges facing volunteer-led tobacco cessation efforts in urban slums in India, including counseling issues and social norms. Despite obstacles, both volunteers and recipients benefited, indicating promise for community-based approaches for tobacco cessation in low-and middle-income countries.