{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:33:30Z","timestamp":1787009610270,"version":"build-2736575974"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The tobacco epidemic in India involves extensive use of smoking and smokeless tobacco products, with nearly 24 million dual users (using both forms) in 2016\u201317. Tobacco cessation among dual users remains underexplored. This study examines the pattern and determinants of tobacco cessation among dual users using the transtheoretical model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from two rounds of the Global Adult Tobacco Survey, India (2009\u201310 and 2016\u201317) were used (pooled sample of 6956 current dual users) to estimate the prevalence of tobacco cessation stages (precontemplation, contemplation, preparation, and relapse). We modelled association with cessation stages using multinomial logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>About 43% of dual users were in precontemplation, 10% in contemplation, 23% in preparation, and 24% in relapse in 2009\u201310. These proportions shifted to 48%, 8%, 17%, and 27%, respectively, in 2016\u201317. The regression model indicated significant temporal influence, with dual users in 2016\u201317 more likely to be in precontemplation [relative risk ratio (RRR): 1.59], contemplation (RRR: 1.37), and relapse (RRR: 1.88) than in 2009\u201310. Age, gender, wealth quintile, region, and exposure to tobacco-related health warnings were significant predictors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Addressing dual tobacco use requires targeted cessation interventions that consider regional and contextual factors to support users through the stages of readiness to quit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pubmed\/fdaf067","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T06:18:24Z","timestamp":1750054704000},"page":"584-593","source":"Crossref","is-referenced-by-count":1,"title":["Tobacco cessation among dual users: analysis of two rounds of Global Adult Tobacco Survey, India"],"prefix":"10.1093","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5361-5389","authenticated-orcid":false,"given":"Shailendra","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Community Medicine & School of Public Health , , Chandigarh 160012 ,","place":["India"]},{"name":"Post-graduate Institute of Medical Education and Research (PGIMER) , , Chandigarh 160012 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilesh","family":"Gawde","sequence":"additional","affiliation":[{"name":"School of Health Systems Studies, Tata Institute of Social Sciences , Mumbai 400088 ,","place":["India"]},{"name":"Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research , Wardha, Maharashtra 442005 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G K","family":"Mini","sequence":"additional","affiliation":[{"name":"Global Institute of Public Health, Ananthapuri Hospitals and Research Institute , Trivandrum, Kerala 695024 ,","place":["India"]},{"name":"Department of Public Health Dentistry, Saveetha Dental Colleges & Hospitals, Saveetha Institute of Medical and Technical Sciences , Chennai, Tamil Nadu 600077 ,","place":["India"]},{"name":"Women\u2019s Institute for Social and Health Studies (WISHS), Women\u2019s Social and Health Studies Foundation , Thiruvananthapuram, Kerala 695011 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"2025082909340374100_ref1","doi-asserted-by":"publisher","first-page":"1005103","DOI":"10.3389\/fpubh.2023.1005103","article-title":"Prevalence of smokeless tobacco use in India and its association with various occupations: A LASI study","volume":"11","author":"Bharati","year":"2023","journal-title":"Front Public Health"},{"key":"2025082909340374100_ref2","first-page":"209","article-title":"Global tobacco report","author":"World Health Organisation","year":"2019"},{"key":"2025082909340374100_ref3","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1136\/tobaccocontrol-2021-056535","article-title":"Evolution of the global smoking epidemic over the past half century: Strengthening the evidence base for policy action","volume":"31","author":"Dai","year":"2022","journal-title":"Tob Control"},{"key":"2025082909340374100_ref4","doi-asserted-by":"publisher","first-page":"41","DOI":"10.4103\/ijmr.IJMR_27_18","article-title":"Determinants of smokeless tobacco use in India","volume":"148","author":"Thakur","year":"2018","journal-title":"Indian J Med Res"},{"key":"2025082909340374100_ref5","author":"Tata Institute of Social Sciences and Ministry of Health and Family Welfare, Government of India. 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