{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T03:08:59Z","timestamp":1763867339796,"version":"3.37.3"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T00:00:00Z","timestamp":1672790400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["FCTC 2030: SESRL 1815768(65629)"],"award-info":[{"award-number":["FCTC 2030: SESRL 1815768(65629)"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.1371\/journal.pgph.0001349","type":"journal-article","created":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T18:23:26Z","timestamp":1672856606000},"page":"e0001349","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Qualitative analysis to identify determinants of use among different occupational settings and channels of communication to address smokeless tobacco use in Sri Lanka"],"prefix":"10.1371","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3925-7888","authenticated-orcid":true,"given":"Hemantha","family":"Amarasinghe","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilantha","family":"Ratnayake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sajeeva","family":"Ranaweera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thirupathy","family":"Suveendran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Palitha","family":"Abeyakoon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,1,4]]},"reference":[{"issue":"4","key":"pgph.0001349.ref001","doi-asserted-by":"crossref","first-page":"357","DOI":"10.4103\/0019-509X.107729","article-title":"Smokeless tobacco use in Sri Lanka","volume":"49","author":"L Somatunga","year":"2012","journal-title":"Indian J Cancer"},{"issue":"6","key":"pgph.0001349.ref002","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.31557\/APJCP.2021.22.6.1753","article-title":"A Sociological Analysis and Exploration of Factors Associated with Commercial Preparations of Smokeless Tobacco Use in Sri Lanka","volume":"22","author":"M Mahees","year":"2021","journal-title":"Asian Pac J Cancer Prev"},{"key":"pgph.0001349.ref003","unstructured":"Ministry of Health Sri Lanka. WHO: STEPWise approach to chronic disease risk factor surveillance year 2015, https:\/\/www.who.int\/ncds\/surveillance\/steps\/STEPS-report-2015-Sri-Lanka.pdf Accessed on 20\/03\/2020."},{"key":"pgph.0001349.ref004","unstructured":"World Health Organization. Global Health Tobacco Survey, Sri Lanka. Fact Sheet. 2015."},{"issue":"4","key":"pgph.0001349.ref005","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.oraloncology.2010.01.017","article-title":"Betel-quid chewing with or without tobacco is a major risk factor for oral potentially malignant disorders in Sri Lanka: a case-control study","volume":"46","author":"H Amarasinghe","year":"2010","journal-title":"Oral Oncol"},{"issue":"5","key":"pgph.0001349.ref006","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1136\/tobaccocontrol-2017-053791","article-title":"Economic cost of tobacco-related cancers in Sri Lanka","volume":"27","author":"H Amarasinghe","year":"2018","journal-title":"Tobacco control"},{"key":"pgph.0001349.ref007","unstructured":"National Cancer Control Programme MoH, Nutrition & Indigeneous Medicine, Sri Lanka,. Cancer Incidence Data: Sri Lanka Year 2019. 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National Oral Health Survey, Sri Lanka (2015\/2016), Colombo: Ministry of Health, Nutrition and Indigenous Medicine (Sri Lanka); http:\/\/www.moh.gov.lk. 2015\u201316."},{"issue":"6","key":"pgph.0001349.ref012","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1111\/j.1600-0528.2010.00566.x","article-title":"Public awareness of oral cancer, of oral potentially malignant disorders and of their risk factors in some rural populations in Sri Lanka","volume":"38","author":"H Amarasinghe","year":"2010","journal-title":"Community Dent Oral Epidemiol"},{"issue":"1","key":"pgph.0001349.ref013","first-page":"58","article-title":"Awareness of oral cancer and precancer among patients attending a hospital in Sri Lanka","volume":"6","author":"A Ariyawardana","year":"2005","journal-title":"Asian Pac J Cancer Prev"},{"key":"pgph.0001349.ref014","unstructured":"Demographics of Sri Lanka. https:\/\/en.wikipedia.org\/wiki\/Demographics_of_Sri_Lanka Accessed on 23\/03\/2020."},{"issue":"5","key":"pgph.0001349.ref015","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1136\/tobaccocontrol-2016-053564","article-title":"Cost-effectiveness of a smokeless tobacco control mass media campaign in India","volume":"27","author":"N Murukutla","year":"2018","journal-title":"Tob Control"},{"issue":"4","key":"pgph.0001349.ref016","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1136\/tobaccocontrol-2016-052968","article-title":"Raw and real: an innovative communication approach to smokeless tobacco control messaging in low and middle-income countries","volume":"26","author":"T Turk","year":"2017","journal-title":"Tob Control"},{"issue":"1","key":"pgph.0001349.ref017","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1136\/tc.2010.039438","article-title":"Results of a national mass media campaign in India to warn against the dangers of smokeless tobacco consumption","volume":"21","author":"N Murukutla","journal-title":"Tob Control"},{"issue":"1","key":"pgph.0001349.ref018","doi-asserted-by":"crossref","first-page":"25","DOI":"10.4103\/ijmr.IJMR_2063_17","article-title":"Smokeless tobacco control: Litigation & judicial measures from Southeast Asia","volume":"148","author":"A Yadav","year":"2018","journal-title":"Indian J Med Res"},{"issue":"2","key":"pgph.0001349.ref019","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.jobcr.2021.01.013","article-title":"Evaluation of a social marketing campaign for the early detection of oral potentially malignant disorders and oral cancer: Sri Lankan experience","volume":"11","author":"H Amarasinghe","year":"2021","journal-title":"J Oral Biol Craniofac Res"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0001349","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,4]],"date-time":"2023-01-04T18:23:42Z","timestamp":1672856622000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0001349"}},"subtitle":[],"editor":[{"given":"Palash Chandra","family":"Banik","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2023,1,4]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,4]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0001349","relation":{},"ISSN":["2767-3375"],"issn-type":[{"type":"electronic","value":"2767-3375"}],"subject":[],"published":{"date-parts":[[2023,1,4]]}}}