Evaluating the effect of 8-week behavioral counselling on smokers with low dependence and correlating with salivary cotinine levels in South Indian working men - A preliminary study

Context: The behavioural counselling is an effective method to bring awareness and prevent tobacco-associated cancers in subjects with low dependence. A pilot study was done to evaluate the effectiveness of an 8-week-based behavioural counselling, in which salivary cotinine among lower nicotine dependence smoking men (as per Fagerstrom scale) was assessed before and after counselling sessions. Aims: This study aims to compare salivary cotinine levels in male smokers with lower dependence before and after 8-week behavioral counselling sessions. Setting and Design: This was an observational pilot study. Materials and Methods: The study involved 46 smokers, recruited after subjecting to inclusion and exclusion criteria. The individuals were scored based on Fagerstrom test of nicotine dependence (FTND) as “low nicotine dependent and very low dependence.” The unstimulated saliva was collected from the participants in the pre-counselling sessions and subsequently on the 1 st , 3 rd , 7 th , and 8 th week post-quit date. The samples were analyzed for cotinine levels using enzyme-linked immunosorbent assay before and after the counselling sessions. Statistical Analysis: Percentages and proportions; Chi-square (χ 2 ) test, Student’s independent t -test, and one-way analysis of variance. Results: Among sample of 46 smokers, 74% ( n = 43) belonged to “very low dependence” and 26% ( n = 12) with “low dependence.” The post-counselling salivary cotinine values were significantly low (19.54 ± 10.2) against the pre-counselling values of the (26.7 ± 10.1) samples(p<0.05). Conclusion: This study proved that a non-invasive, non-pharmacological technique such as an 8-week behavioural counselling helped smokers with lower dependence (FTND scores <6) of tobacco. Future studies can be considered in adopting this method for smokers with high tobacco dependence.