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Case report
One size doesn’t fit all: contouring and addressing social vitals in reversing tobacco epidemic in Punjab, India
  1. Garima Bhatt1,
  2. Sonu Goel1 and
  3. Gagandeep Shergill2
  1. 1Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  2. 2Department of Health and Family Welfare, Government of Punjab, India
  1. Correspondence to Dr Sonu Goel; sonugoel007{at}


There are many tobacco users who wish to quit. In some cases, ostracism related to religious proscriptions serves as a barrier and prevents them from revealing their addiction status. Religion as an institution has an immense influence on human behaviour. It contributes to the cultural identity of individuals, moderating uniformity in their behaviour and social life. We describe a case from a province in Punjab in North India, where tobacco use is a ‘taboo’ due to the widely practised faith of Sikhism. The case illustrates how a doctoral thesis student, along with the healthcare providers at a non-communicable disease clinic, overcame the concealment of tobacco use of a patient with hypertension due to fear of social exclusion. The student assisted him in quitting tobacco use through a culturally specific, patient-centric, individualised, behavioural intervention using religion as a backdrop. This case study highlights the importance of recognising and appreciating the dynamics of sociocultural factors to develop a suitable and successful deaddiction strategy. This case elaborates how a simple ‘nudge’ of religious tenets-based counselling helps the tobacco addict transgress or tide over such barriers.

  • hypertension
  • tobacco control counselling
  • public health
  • tobacco related disease
  • smoking and tobacco

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  • Contributors SG conceptualised the idea and the design. GB carried out the enrolment and acquisition of data, followed by interpretation. GS was involved in the treatment of the patient. GB drafted the manuscript, which was critically revised for intellectual content by SG and GS. The manuscript was approved by all authors before submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.