Dual Burden of Smoked and Smokeless Tobacco Use in India, 2009–2017: A Repeated Cross-Sectional Analysis Based on Global Adult Tobacco Survey

2020 ◽  
Vol 22 (12) ◽  
pp. 2196-2202 ◽  
Author(s):  
Prashant Kumar Singh ◽  
Amit Yadav ◽  
Pranay Lal ◽  
Dhirendra N Sinha ◽  
Prakash C Gupta ◽  
...  
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Rural Areas ◽  
Public Awareness ◽  
Intention To Quit ◽  
Dual Use ◽  
Cross Sectional ◽  
Tobacco Products ◽  
Dual Burden

Abstract Introduction The dual use of smoked and smokeless tobacco (SLT) poses a serious challenge to tobacco control efforts. This article examines the trends and patterns of this usage in India during the period 2009–2010 and 2016–2017. Methods Data from two rounds of nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009–2010 and 2016–2017 have been used. Dual use was assessed based on current smokers and SLT users in both rounds. Results Findings reveal that dual use in India has dropped from 5.3% during 2009–2010 to 3.4% during 2016–2017, a decline of nearly 10 million dual users. However, some states have added nearly 4.6 million new dual users during this period. While dual use continues to remain high in rural areas, there has been a manifold increase in urban areas. Findings revealed that intention to quit tobacco was lower among dual tobacco users as compared to single users with considerable difference between urban and rural areas. Conclusion Easy availability and affordability of SLT products compared to smoking products and restrictions on smoking in public places may have pushed current smokers and dual users to take to or intensify their SLT consumption. Measures relating to awareness, pricing, taxation, and enforcement of tobacco control laws should focus on all forms of tobacco, especially targeting high dual burden in rural and urban settings. Implications Dual form of tobacco users represent 12% of all tobacco users in the country. The study reveals that intention to quit tobacco among dual users is significantly lower than that among single tobacco product users. This requires improving public awareness about the morbidity and mortality that arises from the use of all forms of tobacco products. Efforts to restrict the availability of tobacco products should focus on licensing the sale of all tobacco products. Reduction in dual tobacco use will not only result in multiplied health benefits but also help in achieving the Non-Communicable Diseases targets under the United Nations Sustainable Development Goals.

scholarly journals Geographic variation in tobacco use in India: a population-based multilevel cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. e033178
Author(s):  
Ankur Singh ◽  
Monika Arora ◽  
Rebecca Bentley ◽  
Matthew J Spittal ◽  
Loc G Do ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Dual Use ◽  
Cross Sectional ◽  
Tobacco Products ◽  
Local Areas ◽  
Smokeless Tobacco Use

ObjectiveThis study aims to quantify the extent to which people’s use of tobacco products varies by local areas (city ward and village) across India and the variation in this clustering by tobacco products.DesignCross-sectional study.Setting and participantsData on 73 954 adults across 2547 city wards and villages were available for analysis from 30 states and 2 union territories in India.Primary and secondary outcome measuresWe included as primary outcomes self-reported any tobacco use, current cigarette smoking, current bidi smoking, current smokeless tobacco use and a derived variable for dual use describing respondents who engaged in both smoking and smokeless tobacco use.ResultsThe median risk of an individual using tobacco was 1.64 times greater if a person hypothetically moved from an area of low to high risk of tobacco use (95% CI: 1.60 to 1.69). Area-level partitioning of variation differed by tobacco product used. Median ORs ranged from 1.77 for smokeless tobacco use to 2.53 for dual use.ConclusionsTobacco use is highly clustered geographically in India. To be effective in India, policy interventions should be directed to influence specific local contextual factors on adult tobacco use. Where people live in India influences their use of tobacco, and this association may be greater than has been observed in other settings. Tailoring tobacco control policies for local areas in India may, therefore, provide substantial public health benefits.

scholarly journals An Analysis of the Anti-Tobacco Laws in Bangladesh

2018 ◽  
pp. 1-15
Author(s):  
Abdullah Khan
Keyword(s):  
Public Health ◽  
Tobacco Control ◽  
Smokeless Tobacco ◽  
Rural Areas ◽  
Health Concern ◽  
Global Public Health ◽  
Tobacco Products ◽  
Usage Control ◽  
Legal Provisions ◽  
Harmful Effects

Tobacco use is the leading preventable cause of morbidity and death. It is the global public health concern. In Bangladesh it is related to the tradition and also consider as a taboo of the society, that’s why people are not conscious about the harmful effects of the tobacco. The women, children and aged people are in high risk of the probable effects of tobacco. The cultivation of the tobacco also damage, displaced and unfertile the soil and putting harmful effects on environment, economy and social norms. There different patterns of tobacco as smoked or smokeless tobacco consumption (SLT). The urban people a little bit concern about the smoked tobacco rather than smokeless tobacco and the rural people have no idea about the harmful effects on smoked and smokeless tobacco. In rural areas it’s the tradition of smokeless tobacco consuming. The passive smoking also put the non-smoker specially child and aged person in high health risk. To prevent such situation Bangladesh signed the WHO Framework Convention on Tobacco Control in 2003 and ratifies in 2004 respectively and enacted laws such as “Smoking and Tobacco Products Usage (Control) Act 2005 (Amendment 2013) and related rules in 2015 as “The Smoking and Tobacco products Usage (Control) Rules 2015 and also includes some other Metropolitan Acts. The HC Division also banned the advertisement of all forms of tobacco and tobacco products by the case of Pro. Nurul Islam case (2000). This dissertation analysis the harmful effects of the tobacco usages and smoked and smokeless tobacco on Public Health, Social and Environment. This dissertation analysis the present status of tobacco control in Bangladesh and existing laws regarding to the tobacco control in Bangladesh as well. This research also examines the leading case – Prof. Nurul Islam Case for the banning of the advertisement of tobacco products as well as landmark guidelines from the High Court Division. This dissertation also analysis the loopholes of existing anti-tobacco laws in Bangladesh as well as the comparison of the legal provisions existing laws with the Indian existing laws. This dissertation also examines the activities of the government and different kinds of NGOs in Bangladesh. And lastly fifth and sixth chapter deals with the findings and recommendations that need to be implemented.

Patterns of Smokeless Tobacco Use by Young Adolescents

PEDIATRICS ◽  
1993 ◽  
Vol 91 (1) ◽  
pp. 75-78
Author(s):  
Anita Gottlieb ◽  
Sandra K. Pope ◽  
Vaughn I. Rickert ◽  
Brian H. Hardin
Keyword(s):  
Alcohol Use ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Rural Areas ◽  
Educational Interventions ◽  
Young Adolescents ◽  
Tobacco Products ◽  
Smokeless Tobacco Products ◽  
Continued Use ◽  
Smokeless Tobacco Use

The use of smokeless tobacco products by adolescents has reportedly increased. The purpose of this study was to examine the use of smokeless tobacco by young adolescents across geographic locations and to look at patterns of use and variables associated with continued use beyond experimentation. Participants were 2018 students in sixth through ninth grades. Forty-five percent were male and 76% were white. Use of smokeless tobacco products was reported by 12% of the total population, and 25% reported smoking. Smokeless tobacco use was associated with cigarette smoking, alcohol use, and parental substance abuse. Those reporting alcohol use were more than four times more likely to be users of smokeless tobacco than nondrinkers. We found increased age, being male, being white, smoking, drinking, perceived effects of smokeless tobacco use, and friends' smoking behavior to be significantly associated with continued use beyond experimentation. Smokeless tobacco use was reportedly greater in rural areas. Adolescents who reported initiating use between 6 and 8 years of age were using on a more frequent basis than those who had initiated use when older. This study demonstrated the need for targeting elementary schools for educational interventions aimed at reducing smokeless tobacco use.

scholarly journals Factors Associated with Smokeless Tobacco Use among Pregnant Women in Rural Areas of the Southern Terai, Nepal

2017 ◽  
Vol 15 (1) ◽  
pp. 12-19 ◽  
Author(s):  
Jitendra Kumar Singh ◽  
Dilaram Acharya ◽  
Rajendra Kadel ◽  
Samaj Adhikari ◽  
Daniel Lombard ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Pregnant Women ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Cluster Sampling ◽  
Cross Sectional ◽  
Smokeless Tobacco Use ◽  
Pregnant Mothers

Background: Tobacco use among women during pregnancy leading to poor maternal and child health outcomes has been well documented. However, factors influencing use of smokeless tobacco in Nepal has not yet been well established. This study aims at exploring the factors related to smokeless tobacco use among pregnant women in rural southern Terai of Nepal.Methods: A community-based cross-sectional study was performed at 52 wards within 6 Village Development Committee in Dhanusha district of Nepal. A total of 426 expectant mothers in their second trimester were selected using a multistage cluster sampling method. Descriptive and regression analyses were done to explore the factors that influence smokeless tobacco use.Results: In a total of 426 pregnant mothers, one in five used tobacco in any form. Among the users, 13.4% used smokeless tobacco. Pregnant mothers who were smoking tobacco (AOR 6.01; 95% CI (1.88-19.23), having alcohol consumption (AOR 3.86; 95% CI (1.23-12.08), stressed (AOR 5.04; 95% CI (1.81-14.03), non-vegetarian (AOR 3.31;(1.84-13.03), not attending regular mothers’ group meetings (AOR 4.63; (1.41-15.19), and not-exposed to mass media (AOR 5.02; (1.89-13.33) were significantly associated with smokeless tobacco use. Similarly, mothers of age group 20-34 years, dalit, aadibasi and janajati, hill origin, no education and primary education were more likely to use smokeless tobacco than their counterparts.Conclusions: Factors such as smoking tobacco, alcohol consumption, stress, and poor education were found to be significantly associated with smokeless tobacco use among pregnant women in southern Terai of Nepal. This requires an immediate attention develop an effective strategy to prevent and control smokeless tobacco use among pregnant women in southern Terai of Nepal.

scholarly journals Assessment of nicotine dependence among tobacco users visiting outreach programs in Dharan, Nepal: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Krishna Subedi ◽  
Ashish Shrestha ◽  
Tarakant Bhagat
Keyword(s):  
Tobacco Control ◽  
Nicotine Dependence ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Outreach Programs ◽  
Nicotine Dependency ◽  
The Mean

Abstract Background Nicotine is a highly addictive substance present in tobacco. This study was conducted to assess the level of nicotine dependence among smokers and smokeless tobacco users visiting dental outreach programs of B.P. Koirala Institute of Health Sciences -Dharan, Nepal. Methods A cross sectional study was conducted from June 2018 to April 2019. A total of 726 people were selected from participants of dental outreach programs of 6 districts using convenience sampling technique. The data collection was done using semi-structured questionnaire through face-to-face interview by a single researcher. History of tobacco use and level of nicotine dependency was measured using Nepali translated and validated form of Fagerström Test for Nicotine Dependence for smoking and smokeless tobacco. The mean age of the tobacco users was 39.55 ± 15.57. Descriptive statistics including the mean, median, percentage, standard deviations and interquartile range were computed. Chi-square test, Fisher’s exact test, univariate and bivariate logistic regression were used where needed. Results Nicotine dependence (moderate and severe) was found in 80% of smokeless tobacco users and 48% of smokers. Among the smokeless tobacco users, nicotine dependency was found to be more with increase in duration of tobacco use (AOR = 50.25, 95%CI = 3.51–718.62, p = 0.004), low socioeconomic status (AOR = 6.27, 95%CI = 1.30–30.31, p = 0.02), less number of tobacco packets used per day and tried to quit tobacco use in last 1 year. Among smokers nicotine dependency was found to be significantly higher with smoking more than 10 cigarettes per day (AOR = 7.14, 95% CI = 2.00–25.40, p = 0.002). Conclusions The study concluded that level of nicotine dependence for both smoking and smokeless tobacco was high among the people visiting dental outreach programs. It is high time to develop a policy to control tobacco use along with creating tobacco cessation centers. Currently, tobacco control program is mostly focusing on smoking. However, it is also important to incorporate smokeless tobacco control at policy level.

scholarly journals Associations of Tobacco Advertising Appeal With Intentions to Use Alternative Tobacco Products Among Young Tobacco Users Experiencing Homelessness

2019 ◽  
Vol 34 (2) ◽  
pp. 132-141 ◽  
Author(s):  
William G. Shadel ◽  
Joan S. Tucker ◽  
Rachana Seelam ◽  
Daniela Golinelli ◽  
Daniel Siconolfi
Keyword(s):  
Los Angeles ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Homeless Youth ◽  
Electronic Cigarettes ◽  
Tobacco Product ◽  
Cross Sectional ◽  
Tobacco Products ◽  
Tobacco Advertising ◽  
Advertising Appeal

Purpose: Virtually nothing is known about the potential effects of tobacco advertising on tobacco use among youth experiencing homelessness, a vulnerable population with high tobacco use rates. This study examines associations between the appeal of advertising for 5 classes of tobacco product (electronic cigarettes, hookah, cigars, cigarillos, and smokeless tobacco) and future intentions to use those products again among homeless youth who had indicated any level of lifetime use. Design: A cross-sectional design was used. Setting: Settings were 25 service and street sites in Los Angeles County. Participants: A probability sample of 469 young tobacco users experiencing homelessness (mean age = 22; 71% male; 29% non-Hispanic White) was recruited. Measures: Assessments included product-specific tobacco advertising appeal and future intentions to use the product again, as well as a range of covariate controls (eg, demographics, homelessness severity, current tobacco use, general advertising exposure). Analysis: Linear regression tested for associations between the appeal of advertising for a specific tobacco product and intentions to use that product again in the future, controlling for myriad covariates. Results: Advertising appeal was positively associated with future intentions to use again for electronic cigarettes ( P = .006) and hookah ( P = .001), but not cigars ( P = .486), cigarillos ( P = .126), or smokeless tobacco ( P = .109). Conclusion: Results suggest that advertising appeal may increase use of certain tobacco products among youth experiencing homelessness. However, differences in themes emphasized by advertising for specific tobacco products could differentially influence use in this population.

scholarly journals Epidemiology of tobacco use in Qatar: Prevalence and its associated factors

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250065
Author(s):  
Ahmad AlMulla ◽  
Ravinder Mamtani ◽  
Sohaila Cheema ◽  
Patrick Maisonneuve ◽  
Jamal Abdullah BaSuhai ◽  
...  
Keyword(s):  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Electronic Cigarettes ◽  
Large Population ◽  
Population Based ◽  
Control Measures ◽  
Health Concern ◽  
Cross Sectional ◽  
Tobacco Products ◽  
Current Tobacco

Tobacco use is a serious public health concern as it causes various deleterious health problems. The aim of this study was to determine the prevalence of tobacco use and various types of tobacco used among a population-based sample of adults 18 years and above in Qatar (residents and expatriates). The study also attempted to assess tobacco use initiation age, tobacco dependency, and to identify factors associated with current tobacco use. This 2019 cross-sectional study was conducted among governmental employees and University students in Qatar using cluster sampling methodology. Study participants completed a self-administered, country-adapted summarized version of the Global Adult Tobacco Survey. 25.2% (n = 1741; N = 6904) of the surveyed sample reported current tobacco use. 21.5% (n = 1481) smoked tobacco (cigarettes, waterpipe, medwakh and cigar) concomitant with other forms of tobacco and only 1.0% (n = 69) were using other forms of tobacco (electronic cigarettes, smokeless tobacco and heat-not-burn tobacco products) and 2.7% (n = 191) did not mention the type of tobacco products used by them. Of the 1550 tobacco users, 42.8% were cigarette smokers, 20.9% waterpipe, 3.2% medwakh (Arabic traditional pipe) and 0.7% cigar. Moreover, 1.9% reported smokeless tobacco use (sweika), 2.0% electronic cigarette use, and 0.3% heat-not-burn tobacco use. The mean age for smoking initiation was 19.7±5.3 (Qataris 18.6±4.8 and non-Qataris 20.3±5.6). Using multivariable logistic regression, significant association was observed between tobacco use and gender, nationality, age, monthly income, living with a smoker, and self-rated health. This large population-based cross-sectional survey provides the first evidence for the prevalence of different types of tobacco use including medwakh smoking among adults (Qataris and non-Qataris) 18 years and above in Qatar. This can serve as a baseline for future research studies on the topic. Based on the review of previous and current tobacco survey findings, it is evident that the prevalence of tobacco use (current) in Qatar has declined suggesting that tobacco control measures implemented by the country have been effective in reducing tobacco consumption.

scholarly journals Current status of periodontitis and its association with tobacco use amongst adult population of Sunsari district, in Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
K. Goel ◽  
S. Sharma ◽  
D. D. Baral ◽  
S. K. Agrawal
Keyword(s):  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Periodontal Diseases ◽  
Adult Population ◽  
Multivariate Logistic Regression Analysis ◽  
Case Definition ◽  
Current Status ◽  
Cross Sectional ◽  
Factors Associated ◽  
Significant Factors

Abstract Background Tobacco products are considered significant, but preventable factors related to initiation and progression of periodontal diseases. We assessed the prevalence of periodontitis and evaluated its association with tobacco use and other factors amongst the adult population of Sunsari district in eastern Nepal. Methods A community-based, cross-sectional study was conducted in rural municipalities in the province one of eastern Nepal. A total of 440 adults were interviewed with a set of a pre-tested semi-structured questionnaire. Data on social demographics, adverse oral habits followed by periodontal clinical examination were recorded. Prevalence of periodontitis was assessed by a case definition provided by CDC-AAP. Univariate and multivariate logistic regression analysis was done to measure the association between tobacco use and other factors with periodontitis. Results The overall prevalence of periodontitis was found to be 71.6%. Majority (85.4%) of tobacco users had periodontitis and they were significantly associated with the disease and its severity. The study identified age groups, 45–65 years (AOR = 7.58, 95% CI 3.93–14.61), plaque accumulation (AOR = 1.01, 95% CI 1.00–1.02), smoking (AOR = 3.14, 95% CI 1.36–7.27), khaini users (smokeless tobacco, AOR = 2.27, 95% CI 1.12–4.61) and teeth loss (AOR = 2.02, 95% CI 1.21–3.38) as the significant factors associated with periodontitis. Conclusion The prevalence of periodontitis is high in the surveyed rural adult population. Cigarette smoking along with the use of smokeless tobacco in the form of khaini were identified as significant factors associated with periodontitis.

scholarly journals Changes in Tobacco Use Patterns during COVID-19 and Their Correlates among Older Adults in Bangladesh

2021 ◽  
Vol 18 (4) ◽  
pp. 1779
Author(s):  
Sabuj Kanti Mistry ◽  
Armm Mehrab Ali ◽  
Md. Ashfikur Rahman ◽  
Uday Narayan Yadav ◽  
Bhawna Gupta ◽  
...  
Keyword(s):  
Older Adults ◽  
Tobacco Use ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Policy Makers ◽  
Use Patterns ◽  
Telephone Interviews ◽  
Related Information ◽  
Structured Questionnaire

The present study explored the changes in tobacco use patterns during the COVID-19 pandemic and their correlates among older adults in Bangladesh. This cross-sectional study was conducted among 1032 older adults aged ≥60 years in Bangladesh through telephone interviews in October 2020. Participants’ characteristics and COVID-19-related information were gathered using a pretested semi-structured questionnaire. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic (6 months prior to the survey). Nearly half of the participants (45.6%) were current tobacco users, of whom 15.9% reported increased tobacco use during the COVID-19 pandemic and all others had no change in their tobacco use patterns. Tobacco use was significantly increased among the participants from rural areas, who had reduced communications during COVID-19 compared to pre-pandemic (OR = 2.76, 95%CI:1.51–5.03). Participants who were aged ≥70 years (OR = 0.33, 95% CI: 0.14–0.77), widowed (OR = 0.36, 95% CI: 0.13–1.00), had pre-existing, non-communicable, and/or chronic conditions (OR = 0.44, 95% CI: 0.25–0.78), and felt themselves at the highest risk of COVID-19 (OR = 0.31, 95% CI: 0.15–0.62), had significantly lower odds of increased tobacco use. Policy makers and practitioners need to focus on strengthening awareness and raising initiatives to avoid tobacco use during such a crisis period.

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