Quitting Khaini: A Simple Model's Big Impact

Priya Bala's reliance on khaini, a smokeless tobacco product, until developing a painful mouth ulcer underscores a critical public health issue in India. Her experience illustrates the need to embed tobacco-cessation support within routine healthcare, moving beyond specialist clinics.

The review published in the New England Journal of Medicine emphasizes the Ask-Advise-Connect model. This strategy encourages healthcare providers to inquire about tobacco use, advise patients to quit, and directly connect them with cessation services like quit lines or counseling.

India grapples with a substantial burden from both smoking and smokeless tobacco, impacting over 250 million adults. The health consequences include increased risks of cardiovascular disease, stroke, various cancers, and oral diseases.

While India has implemented numerous tobacco-control measures, including national quitline services and mobile-based interventions, awareness remains a barrier. The review suggests that evidence-based cessation care, combining behavioral support with pharmacological treatment, is essential.

To reach those in rural areas or facing additional barriers, community-based interventions and the involvement of frontline health workers are vital. This approach of identifying tobacco use, advising quitting, and providing accessible help holds lessons for other low- and middle-income countries.