***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Tobacco smoking is an integral part of prison life and an established part of the culture . Little attention has been paid to prevention of smoking in prison . Approximately 70–80 % of prisoners have been identified as current smokers . Aim : To assess the effectiveness of smoking cessation intervention among male prisoners at Central Jail , Bangalore city . Aim : To assess the effectiveness of smoking cessation intervention among male prisoners at Central Jail , Bangalore city . Material s and Methods : A r and omized controlled trial was planned among male prisoners in Central Jail , Bangalore city . There were 1600 convicted prisoners . A self-administered question naire was given to the prisoners to assess their smoking behavior by which prevalence of tobacco smoking was found . Exactly 1352 tobacco users were studied . Among them , there were 1252 smokers . Based on inclusion criteria and informed consent given by the prisoners , a sample of 600 was chosen for the study by systematic r and om sampling . Among the 600 prisoners , 300 were r and omly selected for the study group and 300 for the control group . Results : Prevalence of tobacco smoking among the prisoners was 92.60 % . In the present study , after smoking cessation intervention , 17 % showed no change in smoking , 21.66 % reduced smoking , 16 % stopped smoking , and 45.33 % relapsed ( P < 0.0001 ) at the end of 6-month follow-up in the study group . Conclusion : Tobacco use was high among the prisoners .  Tobacco reduction is possible in the prison even if the living conditions are not favorable . Relatively high rate of relapse in our study indicates that some policies should be adopted to improve smokers ’ information on consequences of tobacco on health and motivational intervention should be added to prisoners INTRODUCTION Tobacco use in low- to middle-income countries is a major public health concern for both smokers and those exposed to environmental tobacco smoke ( ETS ) . Egypt has made important strides in controlling tobacco use , but smoking and ETS remain highly prevalent . This r and omized intervention sought to improve the target population 's knowledge regarding the hazards of smoking and ETS and to change attitudes and smoking behaviors within the community and the household . METHODS In this 2005 - 2006 study in Egypt 's Qalyubia governorate , trained professionals visited schools , households , mosques , and health care centers in rural villages r and omly selected for the intervention to discuss the adverse effects of smoking and ETS exposure and ways to reduce one 's ETS exposure . Data collected in interviewer-facilitated surveys before and after the intervention period were analyzed in pairwise comparisons with data from control villages to assess the effectiveness of the intervention in achieving its aims . RESULTS The intervention group showed a greater increase in underst and ing the dangers associated with smoking cigarettes and waterpipes  and became more proactive in limiting ETS exposure by asking smokers to stop , avoiding areas with ETS , and enacting smoking bans in the home . However , the intervention had little to no impact on the number of smokers and the amount of tobacco smoked . CONCLUSIONS Results are consistent with previous studies showing that changing smokers ' behavior can be difficult , but community-wide efforts to reduce ETS exposure through smoking bans , education , and empowering people to ask smokers to stop are effective . The method can be generalized to other setting BACKGROUND In India , tobacco consumption is responsible for one of the highest rates of oral cancer in the world , the annual oral cancer incidence is steadily increasing among young tobacco users . Studies have documented efforts taken by physicians , doctors and even dentists , in the form of individual or group counseling to curb tobacco use in smoke or smokeless form . However , which one is more effective , still remains an unanswered question . The aim of the study was to compare the effectiveness of individual and group counseling for cessation of the tobacco habit amongst industrial workers in Pune and to compare quit rates . MATERIAL S AND METHODS An interventional study design was selected for 150 industrial workers which were stratified r and omly into three groups ( control , individual and group counseling groups ) and interventions were provided to individual and group counseling groups over a period of six months , which were then compared with the control group that received brief intervention at the start of the study . RESULTS There was significant difference in the quit rates of the participants in the individual counseling group ( ICG ) and group counseling group ( GCG ) when compared at 6 months with the control counseling group ( CCG ) . In the individual counseling group was 6 % while in group counseling group it was 7.5 % after six months of counseling . CONCLUSIONS No conclusion could be drawn whether individual or group counseling were better interms of quit rates .  Individual and group counseling groups were definitely better than the control group when compared at 3 and 6 months , respectively Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background In response to India 's growing tobacco epidemic , strategies are needed to decrease tobacco use among Indian youth , particularly among those who are economically disadvantaged . The objective of this study was to assess the effectiveness of a school-based life-skills tobacco control program for youth of low socio-economic status in Mumbai and the surrounding state of Maharashtra . We hypothesized that compared to youth in control schools , youth exposed to the program would have greater knowledge of effects of tobacco use ; be more likely to take action to prevent others from using tobacco ; demonstrate more positive life skills and attitudes ; and be less likely to report tobacco use . Methods / Findings Using a quasi-experimental design , we assessed program effectiveness by comparing 8th and 9th grade students in intervention schools to 8th grade students in comparable schools that did not receive the program . Across all schools , 1851 students completed a survey that assessed core program components in early 2010 . The program consisted of activities focused on building awareness about the hazards of tobacco , developing life skills , and advocacy development . The primary outcome measure was self-reported tobacco use in the last 30 days . Findings indicate that 4.1 % of 8th grade intervention students ( OR = 0.51 ) and 3.6 % of 9th grade intervention students ( OR = 0.33 ) reported using tobacco at least once in the last 30 days , compared to 8.7 % of students in the control schools . Intervention group students were also significantly more knowledgeable about tobacco and related legislation , reported more efforts to prevent tobacco use among others , and reported stronger life skills and self-efficacy than students in control schools . Limitations to the study include schools not being r and omly assigned to condition and tobacco use being measured by self-report . Conclusions This program represents an effective model of school-based tobacco use prevention that low-income schools in India and other low- and middle-income countries can replicate BACKGROUND Cervical cancer is the leading cause of cancer mortality among women in India . Because Pap smear screening is not feasible in India , we need to develop effective alternatives . METHODS A cluster-r and omized controlled study was initiated in 1998 in Mumbai , India , to investigate the efficacy of visual inspection with acetic acid ( VIA ) performed by primary health workers in reducing cervical cancer mortality . Four rounds of cancer education and VIA screening were conducted at 24-month intervals in the screening group , whereas cancer education was offered once at entry to the control group . The study was planned for 16 years to include four screening rounds followed by four monitoring rounds . We present results after 12 years of follow-up . Poisson regression method was used to calculate the rate ratios ( RRs ) ; two-sided χ(2 ) was used to calculate the probability . RESULTS We recruited 75360 women from 10 clusters in the screening group and 76178 women from 10 comparable clusters in the control group . In the screening group , we achieved 89 % participation for screening and 79.4 % compliance for diagnosis confirmation . The incidence of invasive cervical cancer was 26.74 per 100000 ( 95 % confidence interval [ CI ] = 23.41 to 30.74 ) in the screening group and 27.49 per 100000 ( 95 % CI = 23.66 to 32.09 ) in the control group . Compliance to treatment for invasive cancer was 86.3 % in the screening group and 72.3 % in the control group . The  screening  group showed a statistically significant 31 % reduction in cervical cancer mortality ( RR = 0.69 ; 95 % CI = 0.54 to 0.88 ; P = .003 ) . CONCLUSIONS VIA screening by primary health workers statistically significantly reduced cervical cancer mortality . Our study demonstrates the efficacy of an easily implementable strategy that could prevent 22000 cervical cancer deaths in India and 72600 deaths in re source -poor countries annually Background India has the second largest diabetic population ( 61 million ) and tobacco users ( 275 million ) in the world . Data on smoking cessation among diabetic patients are limited in low and middle income countries . The objective of the study was to document the effectiveness of diabetic specific smoking cessation counseling by a non-doctor health professional in addition to a cessation advice to quit , delivered by doctors . Methods In our parallel-group r and omized controlled trial , we selected 224 adult diabetes patients aged 18 years or older who smoked in the last month , from two diabetes clinics in South India . Using a computer generated r and om sequence with block size four ; the patients were r and omized equally into intervention-1 and intervention-2 groups . Patients in both groups were asked and advised to quit smoking by a doctor and distributed diabetes specific education material s. The intervention-2 group received an additional diabetes specific 30 minutes counseling session using the 5As ( Ask , Advise , Assess , Assist and Arrange ) , and 5 Rs ( Relevance , Risks , Rewards , Roadblocks and Repetition ) from a non-doctor health professional . Follow up data were available for 87.5 % of patients at six months . The Quit Tobacco International Project is supported by a grant from the Fogarty International Centre of the US National Institutes of Health (RO1TW005969 - 01).The primary outcomes were quit rate ( seven day smoking abstinence ) and harm reduction ( reduction of the number of cigarettes / bidis smoked per day > 50 % of baseline use ) at six months . Results In the intention to treat analysis , the odds for quitting was 8.4 [ 95 % confidence interval ( CI ) : 4.1 - 17.1 ] for intervention-2 group compared to intervention-1 group . Even among high level smokers the odds of quitting was similar . The odds of harm reduction was 1.9 ( CI : 0.8 - 4.1 ) for intervention-2 group compared to intervention-1 group . Conclusions The value addition of culturally sensitive diabetic specific cessation counseling sessions delivered by non-doctor health professional was an impressive and efficacious way of preventing smoking related diabetic complications . Trial Registration Clinical Trial Registry of India ( CTRI/2012/01/002327 OBJECTIVES We assessed the effectiveness of a 2-year multicomponent , school-based intervention design ed to reduce tobacco use rates among adolescents in an urban area of India . METHODS Students from 32 schools in Delhi and Chennai , India , were recruited and r and omly assigned to an intervention or control group . Baseline , intermediate , and outcome data were collected from 2 cohorts of 6th- and 8th- grade students in 2004 ; 14,063 students took part in the study and completed a survey in 2004 , 2005 , or 2006 . The intervention consisted of behavioral classroom curricula , school posters , a parental involvement component , and peer-led activism . The main outcome measures were self-reported use of cigarettes , bidis ( small h and -rolled , often flavored , cigarettes ) , and chewing tobacco and future intentions to smoke or use chewing tobacco . RESULTS Findings showed that students in the intervention group were significantly less likely than were students in the control group to exhibit increases in cigarette smoking or bidi smoking over the 2-year study period . They were also less likely to intend to smoke or chew tobacco in the future . CONCLUSIONS School-based programs similar to the intervention examined here should be considered as part of a multi strategy approach to reducing tobacco use among young people in India BACKGROUND Prevalence of tobacco use is higher in the rural than urban areas of India . Unlike tobacco cessation clinics located in urban areas , community-based smoking cessation intervention has the potential to reach a wider section of the community to assist in smoking cessation in the rural setting . The present study aim ed to assess the effectiveness of a cessation intervention in rural Kerala state , India . MATERIAL S AND METHODS Current daily smoking resident males in the age group 18 - 60 years from four community development blocks in rural Kerala were r and omly allocated to intervention and control groups . The intervention group received multiple approaches in which priority was given to face-to-face interviews and telephone counselling . Initially educational material s on tobacco hazards were distributed . Further , four rounds of counselling sessions were conducted which included a group counselling with a medical camp as well as individual counselling by trained medical social workers . The control group received general awareness training 
    Output:
    
There was supportive evidence that cervical screening and hepatitis B immunisation prevent cancer in LLMICs .