{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:19:26Z","timestamp":1789471166050,"version":"build-2803163510"},"reference-count":85,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T00:00:00Z","timestamp":1683158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Indian Council of Medical Research - Junior Research Fellowship Scheme","award":["3\/1\/3\/JRF-2016\/HRD"],"award-info":[{"award-number":["3\/1\/3\/JRF-2016\/HRD"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>One of the \u2019best buys\u2019 for preventing Non-Communicable Diseases (NCDs) is to reduce tobacco use. The synergy scenario of NCDs with tobacco use necessitates converging interventions under two vertical programs to address co-morbidities and other collateral benefits. The current study was undertaken with an objective to ascertain the feasibility of integrating a tobacco cessation package into NCD clinics, especially from the perspective of healthcare providers, along with potential drivers and barriers impacting its implementation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A disease-specific, patient-centric, and culturally-sensitive tobacco cessation intervention package was developed (published elsewhere) for the Health Care Providers (HCPs) and patients attending the NCD clinics of Punjab, India. The HCPs received training on how to deliver the package. Between January to April 2020, we conducted a total of 45 in-depth interviews [medical officers (n = 12), counselors (n = 13), program officers (n = 10), and nurses (n = 10)] within the trained cohort across various districts of Punjab until no new information emerged. The interview data wereanalyzed deductively based on six focus areas concerning feasibility studies (acceptability, demand, adaptation, practicality, implementation, and integration) using the 7- step Framework method of qualitative analysis and put under preset themes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The respondent\u2019s Mean \u00b1 SD age was 39.2\u00b1 9.2 years, and years of service in the current position were 5.5 \u00b1 3.7 years. The study participants emphasized the role of HCPs in cessation support (theme: appropriateness and suitability), use of motivational interviewing, 5A\u2019s &amp; 5R\u2019s protocol learned during the training &amp; tailoring the cessation advice (theme: actual use of intervention activities); preferred face-to-face counseling using regional images, metaphors, language, case vignettes in package (theme: the extent of delivery to intended participants). Besides, they also highlighted various roadblocks and facilitators during implementation at four levels, viz. HCP, facility, patient, and community (theme: barriers and favorable factors); suggested various adaptations to keep the HCPs motivated along with the development of integrated standard operating procedures (SOPs), digitalization of the intervention package, involvement of grassroots level workers (theme: modifications required); the establishment of an inter-programmatic referral system, and a strong politico-administrative commitment (theme: integrational perspectives).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The findings suggest that implementing a tobacco cessation intervention package through the existing NCD clinics is feasible, and it forges synergies to obtain mutual benefits. Therefore, an integrated approach at the primary &amp; secondary levels needs to be adopted to strengthen the existing healthcare systems.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0284920","type":"journal-article","created":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T17:53:52Z","timestamp":1683222832000},"page":"e0284920","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":11,"title":["Feasibility of tobacco cessation intervention at non-communicable diseases clinics: A qualitative study from a North Indian State"],"prefix":"10.1371","volume":"18","author":[{"given":"Garima","family":"Bhatt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5231-7083","authenticated-orcid":true,"given":"Sonu","family":"Goel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Grover","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bikash","family":"Medhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Jaswal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep Singh","family":"Gill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurmandeep","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,5,4]]},"reference":[{"key":"pone.0284920.ref001","volume-title":"Non-Communicable Diseases Factsheet","author":"World Health Organization","year":"2022"},{"key":"pone.0284920.ref002","volume-title":"Global Status Report on Noncommunicable Diseases 2014","author":"World Health Organization","year":"2014"},{"key":"pone.0284920.ref003","volume-title":"Noncommunicable Diseases Progress Monitor","year":"2022"},{"key":"pone.0284920.ref004","author":"NCD Alliance","journal-title":"Risk Factors and Prevention"},{"key":"pone.0284920.ref005","author":"Tata Institute of Social Sciences, Ministry of Health and Family Welfare Government of India","year":"2017","journal-title":"Global Adult Tobacco Survey (GATS) second round 2016\u201317"},{"issue":"5","key":"pone.0284920.ref006","doi-asserted-by":"crossref","first-page":"73","DOI":"10.4103\/0019-509X.147477","article-title":"Smokeless tobacco use: a meta-analysis of risk and attributable mortality estimates for India","volume":"51","author":"Gupta PC Sinha DNPK","year":"2014","journal-title":"Indian journal of cancer"},{"issue":"11","key":"pone.0284920.ref007","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1056\/NEJMsa0707719","article-title":"A nationally representative case\u2013control study of smoking and death in India","volume":"358","author":"PJB Jha","year":"2008","journal-title":"New England journal of medicine"},{"issue":"2","key":"pone.0284920.ref008","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1093\/ntr\/ntaa154","article-title":"Tullu FT. 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