Effectiveness of a capacity-building training for knowledge and practices of tobacco control and oral cancer prevention: a pre-post study from rural northern India

Q: What was the study design and setting?

The study was a pre-post intervention conducted in one rural block of Varanasi district between January and May 2023.

Q: Who participated and what training did they receive?

A total of 202 ASHAs were enrolled and received a one-day training based on Government of India modules covering epidemiology, cessation counselling, symptom-based oral cancer screening, and relevant legislation.

Q: What were the key findings after the intervention?

Post-training results showed significant improvements across knowledge, attitudes, and practices, including increased willingness to perform symptom-based screening and tobacco cessation counselling, and improved awareness of the COTPA Act.

Sep 22, 2026

Upload by MrHarris58

Smokeless tobacco products and areca nut, widely used in Uttar Pradesh, are strongly linked to oral cancer, one of India’s leading cancers. Despite national guidelines, frontline health workers (ASHAs) are underused for tobacco cessation counselling and symptom-based oral cancer screening. This pre-post study evaluated whether a structured, government-based one-day training improved ASHAs’ knowledge, practices, and legal awareness. Results showed baseline knowledge and screening gaps and significant post-training improvements across domains.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Introduction

Clinical trial registration and keywords

Khanna etal. BMCOral Health (2026) 26:1734 BMC Oral Health [https://doi.org/10.1186/s12903-026-08866-7](https://doi.org/10.1186/s12903-026-08866-7) RESEARCH Open Access Effectiveness of a capacity-building training for knowledge and practices of tobacco control and oral cancer prevention: a pre-post study from rural northern India Divya Khanna 1,2*†, Siva Santosh Kumar Pentapati3†, Priyanka Sharma4†, Tulika Shruti1†, Rajesh Vishawakarma5, Anand Sharma5, P Balasundaram1, Niraj Kr Maurya5, Vijay Kr Maurya5, Rahul Kr Varma5, Atul Budukh2,6, Gauravi Mishra2,7, Satyajit Pradhan2,8 and Pankaj Chaturvedi2,9 Abstract Background Smokeless tobacco products and areca nut, widely used in Uttar Pradesh, are strongly associated with oral cancer, which ranks among the top three cancers in India. Data from the Population-Based Cancer Registry, Varanasi, highlights one of the highest oral cancer burdens across India. Despite the availability of national guidelines, frontline health workers (ASHAs) remain underutilised for tobacco cessation counselling and oral cancer symptombased screening. This study assessed the impact of a structured training intervention on their knowledge, practices, and legal awareness. Methods A pre–post intervention study was conducted in one rural block of Varanasi district between January and May 2023. A total of 202 ASHAs were enrolled through purposive sampling. The one-day training, based on Government of India modules, covered epidemiology, clinical features, determinants of tobacco use, cessation counselling, symptom-based oral cancer screening, and relevant legislation. Data were collected using a validated questionnaire before and after training. Descriptive statistics, Stuart–Maxwell tests, and Spearman’s correlations were applied for analysis. Results Baseline scores revealed substantial knowledge and practice gaps: 45. 6% of ASHAs had poor epidemiological awareness, 56 . 9% poor clinical knowledge, and 81 . 7% poor understanding of determinants of tobacco use. Only 19. 8% reported routinely performing symptom-based screening for oral cancer, and while 64 . 8% “always” provided counselling, legal literacy was limited (only 38 . 1% aware of the COTPA Act) . Following the intervention, significant improvements were observed across all domains (p < 0. 01) . Post-intervention most ASHAs reported willingness for oral †Divya Khanna, Siva Santosh Kumar Pentapati, Priyanka Sharma and Tulika Shruti contributed equally to this work, hence seeking joint first authorship. *Correspondence: Divya Khanna[dkhannakgmc@gmail.com](dkhannakgmc@gmail.com) Full list of author information is available at the end of the article © The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.) Khanna et al. BMC Oral Health (2026) 26:1734 Page 2 of 11 cancer screening (64 . 8%) and provide tobacco cessation counselling (75 . 7%) . Awareness of the COTPA Act increased to 65 .4% . Strong positive correlations were observed between knowledge domains, suggesting synergistic gains. Conclusion A structured, government-e

FAQs

What was the study design and setting?

The study was a pre-post intervention conducted in one rural block of Varanasi district between January and May 2023.

Who participated and what training did they receive?

A total of 202 ASHAs were enrolled and received a one-day training based on Government of India modules covering epidemiology, cessation counselling, symptom-based oral cancer screening, and relevant legislation.

What were the key findings after the intervention?

Post-training results showed significant improvements across knowledge, attitudes, and practices, including increased willingness to perform symptom-based screening and tobacco cessation counselling, and improved awareness of the COTPA Act.

Sep 22, 2026

Upload by MrHarris58