Nicotine dependence, quit intentions, and cessation efforts among daily tobacco-using healthcare students, professionals, and staff in Eastern India: insights from a multicentric study

Tobacco use among healthcare workers compromises their role as cessation advocates. This study focuses on nicotine dependence, quit intentions, and cessation efforts among daily tobacco-using healthcare students, professionals, and staff in Eastern India. A multicentric cross-sectional study using a structured questionnaire was conducted in 24 healthcare institutions across Bihar and Jharkhand during July-August 2023, analysing data from 729 daily tobacco users among a total of 7619 participants. The mean nicotine dependence score was 4.6 ± 2.3, with 49.2% showing moderate dependence, 38.4% low, and 12.3% high. Among daily users, 63.1% expressed quit intentions. Two-thirds (67.9%) attempted to quit in the past year, with 36.6% using nicotine replacement therapy and 62.0% trying unaided. Participants without quit intentions had higher odds of moderate dependence [adjusted odds ratio (AOR) = 9.36] and high dependence (AOR = 28.8). Receiving no cessation advice increased the odds of moderate (AOR = 5.30) and high dependence (AOR = 16.15). Quit intentions were associated with lower nicotine dependence (AOR = 29.9 for low and 4.04 for moderate), receiving quit advice (AOR = 2.03), and awareness of tobacco control laws (AOR = 1.08 per unit). Quit attempts were influenced by quit intentions (AOR = 13.03), lower nicotine dependence (AOR = 2.68 for moderate), and receiving cessation advice (AOR = 2.82). The study population showed moderate nicotine dependence and substantial quit intentions, emphasizing the need for stronger healthcare-led cessation efforts to enhance success and empower healthcare workers as tobacco control advocates.