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Case report
One size doesn’t fit all: contouring and addressing social vitals in reversing tobacco epidemic in Punjab, India


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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