Project Quit Tobacco International, funded by the National Institutes of Health (PI Regents’ Professor Mark Nichter, Co-PIs Professor of Anthropology Mimi Nichter and Myra Muromoto, M.D., Family and Community Medicine) is entering its fifth year of action research in India and Indonesia. The impact of the project is being realized in significant ways that may help save tens of thousands of lives a year or more. In India’s southern state of Kerala, tobacco cessation has for the first time figured in the State’s health action plan as policy makers acknowledge that the high prevalence of tobacco use is contributing to the increasing burden of non-communicable diseases. The current prevalence of smoking among men in Kerala is 36% and the prevalence of chewing is 10%.

Kerala’s Department of Health has decided to incorporate tobacco cessation counseling as a major activity within the primary health care system. On World No Tobacco Day (May 31st), it was announced that tobacco cessation counseling services and clinics will be started immediately in 3,000 to 5,000 sub-centers in all 14 districts of Kerala. To date, over 700 doctors and health workers have been trained in tobacco cessation counseling. The department will also conduct educational programs in the community about the harm of smoking, chewing, and secondhand smoke.

This initiative is supported by Project QTI researchers at the Achutha Menon Centre for Health Science Studies, the public health wing of Sree Chitra Tirunal Institute for Medical Sciences and Technology. It is an important undertaking for India, as there are only 20 tobacco cessation clinics run by the World Health Organization in all of India—for a population of over one billion.

In Indonesia, Project QTI team members organized a large press conference on May 31st that declared Yogyakarta City as “Healthy without Tobacco.” The meeting received wide coverage in the local, national, and international media. Similar to recent developments in India, cessation clinics have been opened in all primary health care centers in Yogyakarta City and both doctors and volunteer health workers have been trained in cessation counseling. Eleven communities in the area have declared themselves as having smoke-free households, an initiative begun under the auspices of Project QTI. QTI is working in both countries to foster community wide smoke-free households as a social movement, making second hand smoke a women’s and children’s health issue, and promoting male responsibility as a cultural value. Kerala is in the process of launching its smoke-free household initiative this year.