ASSIST-Linked Brief Intervention (ALBI) for Reducing Robacco Use Among Male Security Personnel in North India: A Randomized Controlled Trial.

Abstract

Background: Screening and brief intervention have been identified as effective strategies for reducing harmful substance use and its related consequences. The present study evaluated the efficacy of the WHO Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST)-linked brief intervention (ALBI) in reducing risky tobacco use among male security service personnel employed at a tertiary care hospital in North India.

Methods: A randomized controlled trial was conducted in two sequential stages. Stage I involved ASSIST-based screening, and in stage II, moderate- or high-risk ASSIST scores and Fagerström Test for Nicotine Dependence scores were considered the baseline assessment. The intervention group received face-to-face ALBI based on the WHO ASSIST manual, while the control group received general health information. Both groups were followed up on days 15, 45, and 90 using ASSIST and the Fagerström Test for Nicotine Dependence.

Results: Among 600 participants screened, 95 were randomized, and 86 completed follow-ups. The prevalence of moderate-to-high-risk tobacco use was 23.75% (95/400), and both study groups were comparable at baseline (p > .05). The intervention group demonstrated a significant reduction in ASSIST scores across follow-up assessments compared with the control group, with a significant group × time interaction effect (F = 47.92, p = .001, effect size = 0.340). A significant reduction in tobacco dependence was observed in the intervention group on day 15 (χ2 = 9.66, p = .008) and day 45 (χ2 = 6.10, p = .047), although the effect declined by day 90 (χ2 = 5.7, p = .05).

Conclusions: ALBI was effective in reducing risky tobacco use among security guard personnel in this setting. Further trials are recommended to establish its effectiveness in routine workplace settings.