Garhwal Community Development and Welfare Society


We seek to improve the health status of rural and indigenous populations through research, training and service delivery programmes.

— Dr. Rajesh Singh, Director

Ongoing Research

Epidemiological Prevalence Survey of Tobacco Usage, Knowledge and Attitudes in rural and mountainous North India


To increase the understanding around tobacco usage in rural and mountainous North India so to inform the development of quality, integrated and cost effective tobacco control programs to improve their health.


  • To develop and undertake a cross-sectional survey to determine the prevalence of tobacco usage in Uttarakhand state
  • To document the communities knowledge, attitudes and practices around tobacco usage and cessation

Study Design & Methodology

Study Design.

A cross-sectional cluster randomized epidemiological mapping survey was done in rural and mountainous two districts of Uttarakhand state (Tehri and Dehradun). The primary outcomes of interest of this study are to see the prevalence of tobacco usage. These estimates were be accompanied by 95% confidence intervals calculated using standard formulas, and incorporating assumptions in relation to the clustering effect by village and residence unit. These clustering effects were taken into account in all the appropriate analyses.


Tehri and Dehradun district of Uttarakhand, North India: This disadvantaged and backward state of Northern India was chosen as there is little known about tobacco usage in this area. It would be expected that those in the mountain areas have different tobacco usage patterns to those in the plains in India. To our knowledge no other mapping surveys on this topic have been undertaken in this Himalayan region.

Results and outcomes

Selected findings:

In total 1853 adult population participated in the study (929 were men and 924 were women)

  • 93% of all smokers are male and 86% of all tobacco chewers are male.
  • Prevalence of tobacco usage amongst those whose with primary level education was 41% compared with 29.9% for those who had completed higher studies
  • Only 27% of tobacco users had ever tried to stop using tobacco and only 2% of the entire population were ex users
  • 97.7% would like to see less tobacco use in their community.
  • 82% were favor of "clear and prominent messages" on all tobacco products that warn users about the dangers of tobacco


A study to inform integration of informal rural health providers into the formal health system in India.


To guide strategy formulation for upgrading, certifying and legitimizing RHPs in either of 2 ways – (i) either through the new BRHC course, or (ii) through an alternative physician assistant model.Identification of Alzheimer’s disease patients in the sub-Himalayan region and identify and train their care givers.

Study sites:

Rural and tribal districts or regions in each of 2 states – Uttarakhand andTamil Nadu/Andhra Pradesh. Our choice of states is based on two reasons. First, these states present important differences in per capita wealth, geographical location (north and south respectively), terrain (hilly vs plain) and perceived performance of the public health system (e.g. the health system in Tamil Nadu is considered to be one of the best in India). Second, we have local presence and familiarity, with prior experience of having worked in these states.


Asha Resource Center

Asha Training

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Focus Group Discussion

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