Samposhyam Foundation
A culturally grounded qualitative framework for mapping paan and smokeless tobacco exposure in West Bengal, where structured KAP surveys fall short.
Paan consumption in West Bengal is not a simple "knowledge deficit" problem. It is ritualistic, occupational, intergenerational, and deeply woven into social identity. Standard KAP (Knowledge, Attitude, Practice) surveys produce numerically tidy findings that do not faithfully represent the behavioural reality on the ground.
The NOMI-E (Extended) Behavioural Exposure Framework was developed from the ground up for precisely this setting, building on Samposhyam's validated four-pillar methodology from the Sundarbans Delta.
The same four-pillar methodology validated in the Sundarbans (317 codes, 19 themes, 473 relationships), now extended to behavioural exposure mapping for paan and smokeless tobacco.
Supply chains, vendor ecosystems, ingredient availability, zarda/lime/catechu sourcing patterns, seasonal and economic drivers of consumption
Quit attempts and barriers, harm reduction practices, occupational coping, community-level adaptive strategies, NRT readiness signals
Gendered consumption patterns, occupational exposure (drivers, labourers), age-cohort differences, socioeconomic access to cessation support
Intergenerational transmission of paan rituals, cultural framing ("digestive", "mouth freshener"), traditional health beliefs, community credible messengers
Before extending to oral cancer, NOMI was validated through 44 in-depth interviews in the Indian Sundarbans, producing one of the most densely coded qualitative frameworks in food systems research. These are real numbers from our database.
Each pillar connects to every other through directional relationships. The thickness of each connection reflects the number of validated relationships. This interconnectedness is what makes NOMI powerful: it reveals how food system dimensions interact, not just what they contain.
For oral cancer: the same network architecture maps how socioecological supply chains (NSS), quit resilience (OR), gendered exposure (MLE), and cultural transmission (IK) interact to shape paan consumption patterns.
2-3 sites in urban and peri-urban Kolkata. 50-67 participants across 3 purposive groups. Bengali-language fieldwork with audio-recorded transcription.
IRB clearance, instrument development, field researcher training
Exposure mapping instrument with 5-8 participants
6-8 FGDs, 15-20 IDIs, paan composition mapping
Reflexive thematic analysis, member checking
Literature triangulation, CoE scoring
Pilot report, awareness brief, policy recommendations
The Paan Composition Exposure Mapping Instrument captures exact ingredients (zarda, lime, catechu, supari varieties) per preparation, not just "uses tobacco: yes/no."
NOMI has been validated with 317 codes, 473 relationships, and 4,533 evidence records in the Sundarbans. The oral cancer extension (NOMI-E) inherits this methodological rigour.
Users (30-40), vendors/paanwalas (10-15), and community health workers/ASHAs (8-12) give triangulated perspectives that KAP's single-respondent design cannot.
Gender-segregated FGDs, explicit inclusion of women users, occupational groups (drivers, labourers, domestic workers), and age cohorts reveal differential exposure pathways.
CQT convergence scoring and AMRP benchmarking deliver quantified evidence quality metrics, not just themes. Measurable outcomes from day one.
NOMI-E qualitative findings directly inform which populations, which exposure profiles, and which message frames will make NRT intervention most effective.
Samposhyam Foundation's vision is to build a scalable cancer prevention evidence base. NOMI-E provides the qualitative foundation that makes grant applications compelling and interventions context-appropriate.
NOMI-E qualitative mapping, validated instrument, awareness brief
Combined KAP + NRT intervention guided by NOMI-E exposure profiles
Multi-site expansion, grant applications leveraging pilot evidence
Cancer prevention and control centre with evidence-based programme design
The full workable research design, with defined study locations, participant numbers, and named researchers, is in preparation.
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