Social Determinants In Access To Tobacco Prevention And Cessation Support Services Among Migrant Construction Workers In Urban Chennai, India

Context: In spite of the high burden of tobacco consumption among migrants, disparities in the awareness of tobacco-related harms, health-seeking behaviors, and intention to switch to lower risk alternatives remain understudied area. Aims: Assess the social determinants in access to tobacco prevention and cessation support services among migrant construction workers in urban Chennai, India. Settings and Designs: A community-based, cross-sectional study design. Materials and Methods: A questionnaire adapted from GATS survey was used among migrants working across 13 construction sites of Chennai during May-September 2019. A counseling session was provided for the migrant workers who were willing to quit. Statistical Analysis Used: Data entered in MS Excel was analyzed using SPSS and multivariate analysis was performed. Results: Among 345 migrants, 338 (98%) were currently using tobacco and smokeless tobacco (57.4%) consumers. In spite of awareness (84.6%) about tobacco ill-effects on health, only 48% care providers enquired of the tobacco use in the previous one year. Pictorial health warnings were seen by 315 migrants (91.3%) in the past one month, but only 110 migrants (34.9%) considered quitting. The majority (341 migrants, 98.4%) have not heard of the lower risk alternatives such as nicotine gums and lozenges and only 89 migrants (26.33%) agreed to try lower risk alternatives for tobacco on trial basis. Migrant construction workers who were using tobacco less than 5 years (P = 0.001) were more likely to try lower risk alternatives. Conclusions: Reappraising social determinants in access to tobacco prevention and cessation support services to migrant construction workers may be a promising strategy to reduce health harms of tobacco intake.