Qualitative analysis to identify determinants of use among different occupational settings and channels of communication to address smokeless tobacco use in Sri Lanka.

Smokeless tobacco (SLT) use is a leading cause for oral and pharyngeal cancers in the Southeast Asian region which leads to considerable morbidity and mortality. This study aims to Identify the determinants of use and channels of communication to address smokeless tobacco use among specific user groups in Sri Lanka. The study uses a qualitative approach with purposive, snowballing sampling among groups. Specific high-risk demographic and occupational groups that are known to have high prevalence of SLT use were identified in five of the 25 administrative districts of Sri Lanka, were approached. Sixty-two in-depth interviews and 10 focus group discussions were carried out among different occupational groups in five districts. Thematic analysis coding each reported determinants and communication methods was carried out. Users of SLT of different groups revealed different determinants of use. Some of the determinants were common to several groups. When investigated the preferred methods to address SLT, it is found that the media use was also different among these groups. All preferred group level awareness programmes to individual level awareness programmes. Most groups watch specific television channels at specific times of the day. Most groups stated that they accepted the messages of religious leaders and cancer victim groups. Radio and newspapers were used rarely by these groups that were studied. Smart phones were used only by urban youth and others used basic mobile phones only for calling. Different risk groups were identified allowing preparation of an overall communication approach to address use of SLT. The findings here Identify determinants of use and the communication approaches that can be used to prepare an effective communication strategy to address SLT use among different and sometimes hidden groups in resource poor settings in low a middle-income country

Communication strategy.

Communication strategy.</p

Proximal reported determinants of use.

Proximal reported determinants of use.</p

COREQ check list.

(PDF)</p

FCTC 2030 detail presentation.

(PPT)</p

In-depth interview guide.

(DOC)</p

Focus group guide.

(DOC)</p

Distribution of data collection sites and engaged communities.

Distribution of data collection sites and engaged communities.</p

Summary of costing analysis in UDS million.

<p>Summary of costing analysis in UDS million.</p

Economic costs of alcohol use in Sri Lanka

<div><p>Aim</p><p>Alcohol related disease conditions are responsible for a significant proportion of morbidity and mortality in Sri Lanka. This study quantified the economic cost of selected alcohol related disease conditions in Sri Lanka in 2015.</p><p>Methods</p><p>This study uses the prevalence-based cost of illness methodology specified by the World Health Organization, and uses the gross costing approach. The direct costs includes the costs of curative care (inpatient and outpatient care borne by the state and out of pocket expenditure borne by patients) for alcohol related diseases, weighted by the respective population attributable fractions. Indirect costs consist of lost earnings due to absenteeism of the patient and carers due to seeking care and recuperation, and the loss of income due to mortality.</p><p>Data form the Ministry of Health, Registrar General’s Department, Department of Census and Statistics and the National Cancer Registry was used. Systemic and house costs and population attributable fractions were obtained from research studies. Economists, Public Health Experts, Medical Administrators and Clinical Specialists were iteratively consulted during the estimation and validation of the costs and the results.</p><p>Results</p><p>The estimated present value of current and future economic cost of the alcohol-related conditions for Sri Lanka in 2015 was USD 885.86 million, 1.07% of the GDP of that year. The direct cost of alcohol related disease conditions was USD 388.35 million, which was 44% of the total cost, while the indirect cost was USD 497.50 million, which was 66% of the total cost. Road Injury cost was the highest cost category among the conditions studied.</p><p>Conclusion</p><p>Addressing alcohol use and its harms through effective implementation of evidence-based polices and interventions is urgently required to address the economic costs of alcohol use in Sri Lanka as it imposes a significant burden to the country.</p></div