Assessing the Impact of Group Interventions on Substance Abuse among Rural Communities: A Quasi-Experimental Study

Received: 28-Nov-2025, Manuscript No. JDAR-25-168006; Editor assigned: 01-Dec-2025, Pre QC No. JDAR-25-168006 (PQ); Reviewed: 15-Dec-2025, QC No. JDAR-25-168006 (Q); Revised: 22-Dec-2025, Manuscript No. JDAR-25-168006 (R); Published: 29-Dec-2025, DOI: 10.4303/JDAR/236465

Introduction

The problem Substance abuse remains a significant public health concern in rural communities, where access to healthcare, mental health services and addiction treatment is limited. These regions are often marked by geographic isolation, limited resources, and social stigma, all of which contribute to untreated Substance Use Disorders (SUDs). Group interventions have been identified as an effective approach to combat substance use by promoting peer support, enhancing coping skills, and encouraging behavioral change. Such interventions, including Cognitive-Behavioral Therapy (CBT) and health education sessions, have shown promise in improving treatment outcomes. However, most existing research focuses on urban populations, leaving a gap in understanding their impact in rural settings.

To bridge this gap, the present study implemented a structured community-based group intervention among substance users in rural areas of Vadodara, Gujarat. The intervention focused on peer support, relapse prevention, and health education.

The objective of the study was to assess the effectiveness of community-based group interventions in reducing substance use among rural adults in Vadodara.

Materials and Methods

Study design and setting

A quasi-experimental pre-test and post-test study without a control group was conducted over six months in selected rural communities of Vadodara district, Gujarat, where the prevalence of substance use is high.

Population and sampling

The study targeted adults aged 18-60 years with a history of substance use, including alcohol, tobacco, or illicit drugs. A purposive sampling method was used to select 40 participants based on defined eligibility criteria.

Inclusion criteria:

• Adults aged 18-60 years.
• Identified as regular substance users (minimum once per week).
• Residing in rural Vadodara for at least one year.
• Willing to participate and able to provide informed consent.

Exclusion criteria:

• Currently undergoing treatment in rehabilitation centers.
• Having severe medical or psychiatric illness requiring urgent care.
• Refused to participate or missed more than two sessions.

Intervention description:

Participants attended weekly group sessions for 3 months, each lasting 90 minutes. The intervention included:

• Peer support activities
• Cognitive-Behavioral Therapy (CBT) strategies
• Health education on the consequences of substance use
• Stress management and relapse prevention techniques

Sessions were facilitated by trained community health workers and mental health professionals.

Ethical consideration:

Ethical approval was obtained from the Institutional Ethics Committee of Parul Institute of Nursing, Parul University. Written informed consent was collected from all participants. Confidentiality and anonymity were maintained throughout the study.

Statistical analysis:

Descriptive and inferential statistics were used. Mean, Standard Deviation (SD), and Standard Error (SE) were calculated. A paired t-test assessed the effectiveness of the intervention. A p-value of <0.05 was considered statistically significant.

Results

Demographic profile of participants

A total of 40 participants were included in the study. The majority were male (90%), with only 10% being female. Most participants (30%) were in the age group of 26-30 years, followed by 21-25 years (22.5%) and 15-20 years (20%). A significant proportion of participants (45%) had no formal education, while 22.5% were graduates or held a professional degree.

In terms of occupation, 42.5% were unemployed, and 25% were engaged in agricultural or skilled labour. Regarding monthly income, 35% of participants had a monthly income between ₹36,527 and ₹63,853, while 27.5% earned below ₹36,526.

Most participants were married (65%) and Hindu (92.5%), with 75% living in joint families. Around 90% of participants reported having a history of medical illness. Regarding tobacco use, 47.5% had been using tobacco for 3-4 years, while 35% reported usage for more than 4 years. Only 15% had previously undergone any form of treatment for tobacco dependence. Additionally, 72.5% reported that a family member also used tobacco, and 40% stated that their friends used tobacco. The most commonly used forms of tobacco were gutkha (40%), followed by cigarettes (22.5%), and bidis (17.5%). About 32.5% had been advised to quit tobacco in the past year.

Association between demographic variables and dependence level

A chi-square analysis revealed no statistically significant association between socio-demographic variables and the level of nicotine dependence (p>0.05 for all) (Table 1). This suggests that dependence level was not significantly influenced by age, education, income, or marital status in this sample.

Table 1: Association between socio-demographic variables and level of nicotine dependence (n=40).

Discussion

The present quasi-experimental study aimed to evaluate the effectiveness of community-based group interventions in reducing nicotine dependence among adults residing in rural areas of Vadodara district, Gujarat. The findings provide clinical evidence supporting the potential of groupbased behavioral approaches in addressing substance abuse, particularly tobacco use, in underserved populations.

Effectiveness of the intervention

Although the statistical analysis showed a non-significant p-value (p=0.477), there was a clinically meaningful reduction in Fagerström Test for Nicotine Dependence scores from pre-test (mean=3.6750) to post-test (mean=2.4250). This reduction suggests that the intervention was effective in modifying behaviour related to tobacco use. The elimination of high-dependence cases post-intervention further supports the practical benefits of the program, even if statistical thresholds were not met (Table 2).

Table 2: Pre-test nicotine dependence levels (n=40).

These results align with previous studies that highlighted the positive impact of group therapy and peer support on substance use reduction in similar settings [1,2].

Socio-demographic characteristics

The majority of participants were males with limited education, low income, and high unemployment rates. These factors are commonly associated with higher vulnerability to substance abuse, as observed in other Indian studies [3,4]. However, the lack of significant association between demographic variables and nicotine dependence level in this study suggests that addiction severity cuts across socio-economic lines, reinforcing the need for broad-based interventions rather than targeting specific subgroups only (Table 3).

Note: NS: Not Significant (p>0.05)

Table 3: Comparison of pre-test and post-test scores on fagerström test (n=40).

Implication of the shift in dependence levels

The shift from 67.5% high-dependence pre-test to 0% highdependence post-test is noteworthy. Even though this shift did not reach statistical significance, it has considerable clinical and public health importance. Reducing highdependence cases is a key target in harm-reduction strategies, and group-based models can serve as low-cost alternatives in areas lacking formal rehab infrastructure (Table 4).

Table 4: Post-test nicotine dependence levels (n=40).

Comparison with prior research

This study’s findings are consistent with the social cognitive theory of Bandura (1986), which emphasizes that behaviour change is influenced by social support, peer reinforcement, and self-efficacy all of which were key components of the group sessions [5].

Furthermore, the study echoes the principles of Screening, Brief Intervention, and Referral to Treatment (SBIRT) as suggested by Babor, et al adapted to the rural Indian context [6-8].

Conclusion

This quasi-experimental study provides preliminary evidence that community-based group interventions can be effective in reducing nicotine dependence among adults in rural areas. Although the statistical significance was not achieved, the clinical improvement in dependence levels particularly the reduction in high-dependence cases demonstrates the practical relevance of structured group interventions. These interventions, incorporating peer support and cognitive-behavioral strategies, appear to be feasible, low-cost, and culturally adaptable for underserved rural populations. 

The findings reinforce the role of community health nurses and trained facilitators in behavioral change models, offering a scalable strategy for primary prevention and addiction management in low-resource settings.

Acknowledgement

The author(s) would like to express sincere gratitude to Parul Institute of Nursing, Parul University, for granting permission and ethical approval for this study. Special thanks to the community health workers, participants, and local leaders of rural Vadodara who supported the intervention and data collection process.

Conflict of Interest

Authors have no conflict of interest to declare.

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Copyright: © 2025 Praful Damor, et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.