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Huque R, Abdullah SM, Ahmed S, Hossain N, Islam F, Sarker MAB, Amin MN, Ahmed N. Is smokeless tobacco use associated with lower health-related quality of life? A cross-sectional survey among women in Bangladesh. Tob Induc Dis 2024; 22:TID-22-60. [PMID: 38586495 PMCID: PMC10996035 DOI: 10.18332/tid/185969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 03/11/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION Bangladesh has 22 million adult users of smokeless tobacco (ST). The prevalence among women is higher (24.8%). Health-related quality of life outcome (HRQoL) for ST use is little known. We investigated the association between HRQoL and daily ST use among adult women in Bangladesh. METHODS Using multi-stage design, a cross-sectional survey was conducted. Adult women (randomly selected) were surveyed from 4 purposively selected divisions (Dhaka, Chittagong, Khulna and Rangpur). Female ST users and non-users were compared using HRQoL scores. Self-perceived Visual Analogue Scale (EQ-VAS) values and HRQoL scores were modelled to examine their association with ST use. RESULTS A total of 2610 women (1149 users and 1461 non-users) were surveyed. The proportion reported any type of problem in all health dimensions was significantly higher among female ST users than non-users (mobility: 43.3% vs 19.5%, self-care: 29.6% vs 11.9%, usual activities: 48.7% vs 21.8%, pain or discomfort: 69.8% vs 40.6%, and anxiety or depression: 61.3% vs 37.5%). The average HRQoL scores were 0.79 (95% CI: 0.78-0.81) and 0.90 (95% CI: 0.89-0.90) for users and non-users, respectively. Moreover, EQ-VAS average values were significantly higher for non-users [80.7 (95% CI: 79.9-81.6) vs 70.27 (95% CI: 69.2-71.2)]. Controlling the sociodemographics, ST use significantly reduced the HRQoL score by an average of 0.15 points. The EQ-VAS values on average decreased by 0.04 points for ST use. CONCLUSIONS ST use is significantly associated with the HRQoL of females in Bangladesh. Considering the higher prevalence of ST, especially among women, HRQoL hazards need to be communicated for awareness building.
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Affiliation(s)
- Rumana Huque
- Department of Economics, University of Dhaka, Dhaka, Bangladesh
- Research and Development, ARK Foundation, Dhaka, Bangladesh
| | - S M Abdullah
- Department of Economics, University of Dhaka, Dhaka, Bangladesh
- Research and Development, ARK Foundation, Dhaka, Bangladesh
- Department of Health Sciences, University of York, York, United Kingdom
| | - Sayem Ahmed
- School of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Nazmul Hossain
- Department of Economics, University of Dhaka, Dhaka, Bangladesh
- Research and Development, ARK Foundation, Dhaka, Bangladesh
| | - Farhin Islam
- Research and Development, ARK Foundation, Dhaka, Bangladesh
| | - Mohammad A B Sarker
- Health Economics Unit, Health Services Division, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Md Nurul Amin
- Health Economics Unit, Health Services Division, Ministry of Health and Family Welfare, Dhaka, Bangladesh
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Sarker MHR, Moriyama M, Sujon H, Rahman MM, Banu S, Chisti MJ, Ahmed T, Faruque ASG. Smokeless tobacco consumption and its association with risk factors of chronic kidney disease in rural and peri-urban Bangladesh. Tob Induc Dis 2023; 21:138. [PMID: 37869615 PMCID: PMC10588374 DOI: 10.18332/tid/171358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/07/2023] [Accepted: 08/17/2023] [Indexed: 10/24/2023] Open
Abstract
INTRODUCTION Compared to smoking, which has major consequences in chronic kidney disease (CKD) initiation and progression, smokeless tobacco (SLT) consumption is considered to have fewer health consequences. We investigated the prevalence of SLT consumption and its association with risk factors of CKD in a rural and peri-urban Bangladeshi population. METHODS Using random sampling we recruited 872 adults in 2020, from the Mirzapur Demographic Surveillance System of Bangladesh, who had resided in the area for at least five years. Interviews using a semi-structured questionnaire, physical examination and anthropometric measurements were done, followed by blood and urine testing. The blood and urine tests were repeated in selected participants after three months as per the CKD Epidemiology Collaboration equation. RESULTS The prevalence of SLT consumption was 29%. Being aged ≥46 years (OR=7.10; 95% CI: 4.79-10.94), female (OR=1.64; 95% CI: 1.21-2.22), housewife (OR=1.82; 95% CI: 1.35-2.45), farmer (OR=1.71; 95% CI: 1.06-2.76), widow (OR=3.40; 95% CI: 2.24-5.17), and having no formal schooling (OR=4.91; 95% CI: 3.59-6.72), family income of <$100/month (OR=1.66; 95% CI: 1.13-2.43), sleeping duration <7 hours per day (OR=2.33; 95% CI: 1.70-3.19), were associated with a significantly higher odds of SLT consumption. However, being aged 31-45 years (OR=0.25; 95% CI: 0.16-0.38) had significantly lower odds of being an SLT consumer. Among the diseases investigated, undernutrition (OR=1.63; 95% CI: 1.15-2.33), hypertension (OR=1.52; 95% CI: 1.13-2.05), anemia (OR=1.94; 95% CI: 1.39-2.71) and CKD (OR=1.62; 95% CI: 1.15-2.27) were significantly associated with SLT consumption. In the multivariable analysis, being aged 31-45 years (AOR=3.06; 95% CI: 1.91-4.90), ≥46 years (AOR=15.69; 95% CI: 4.64-53.09) and having no formal schooling (AOR=2.47; 95% CI: 1.72-3.55) were found to have a significant association with being an SLT consumer. CONCLUSIONS SLT consumption is associated with most of the established risk factors of CKD within the studied population.
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Affiliation(s)
- Mohammad H R Sarker
- Technical Training Unit, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Michiko Moriyama
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hasnat Sujon
- Technical Training Unit, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
- Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Md M Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Shakila Banu
- Technical Training Unit, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammod J Chisti
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abu S G Faruque
- Nutrition and Clinical Services Division, International Centre for Diarrheal Disease Research, Bangladesh, Dhaka, Bangladesh
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Chen DTH, Nargis N, Fong GT, Huq SM, Quah ACK, Filippidis FT. Perceptions and reasons for quitting and transitioning between smoking and smokeless tobacco products: Findings from four waves of the ITC Bangladesh survey. Tob Induc Dis 2023; 21:25. [PMID: 36819960 PMCID: PMC9936606 DOI: 10.18332/tid/159137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 02/19/2023] Open
Abstract
INTRODUCTION Transitions between different tobacco products are frequent among tobacco users in Bangladesh; however, the reasons leading to such transitions and why they quit are not well researched. The aim of the study is to examine perceptions and reasons reported by tobacco users in Bangladesh to transition to other products or quit. METHODS Data from four waves (2009-2015) of the International Tobacco Control (ITC) Bangladesh Survey were used. Repeated data on perceptions and reasons for exclusive cigarette (n=520), bidi (n=130), and SLT users (n=308) to either start using other products or quit were analyzed with sampling weights. The percentages of responses across waves were used to calculate the pooled proportion data using a meta-analysis approach. RESULTS Common reasonsig for respondents switching to other tobacco products were influence of friends/family (73.8-86.0%), and curiosity (44.4-71.3%). The perceived calming effect of smoking cigarettes and bidis (43.2-56.9%), and the impression that bidis were less harmful (52.3%) and taste better (71.2%) were major reasons for exclusive SLT users to switch products. Health concerns (16.5-62.7%) and disapproval from friends/family (29.8-56.4%) were generally the main reasons for quitting. For smoked tobacco users, doctor's advice (41.6%), package warning labels (32.3%), and price (32.4%) seemed to be the major driving factors to quit. CONCLUSIONS Results highlight that the reasons for switching between tobacco products and quitting include social factors (e.g. friends/family) and (mis) perceptions regarding the products. Tobacco control policy could emphasize cessation support, increased price and education campaigns as key policies to reduce overall tobacco use in Bangladesh. Data from four waves (2009-2015) of the International Tobacco Control (ITC) Bangladesh Survey were used. Repeated data on perceptions and reasons for exclusive cigarette (n=520), bidi (n=130), and SLT users (n=308) to either start using other products or quit were analyzed with sampling weights. The percentages of responses across waves were used to calculate the pooled proportion data using a meta-analysis approach.
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Affiliation(s)
- Daniel T. H. Chen
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom,Primary Care Epidemiology, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, Canada,School of Public Health Sciences, University of Waterloo, Waterloo, Canada,Ontario Institute for Cancer Research, Toronto, Canada
| | | | - Anne C. K. Quah
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Filippos T. Filippidis
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
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Dsouza V, Kembhavi PM, Rao S P, P K, Hebbar PB. How does Indian news media report smokeless tobacco control? A content analysis of the gutka ban enforcement. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001724. [PMID: 36972290 PMCID: PMC10042338 DOI: 10.1371/journal.pgph.0001724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 02/17/2023] [Indexed: 03/29/2023]
Abstract
Smokeless tobacco (SLT) products like gutka and paan masala are a growing public health crisis in India. Despite enacting a ban-the highest form of regulation-little is known about implementation progress. The purpose of this study was to look at how enforcement of gutka ban is covered in Indian news media and if media is a reliable source of data. We conducted a content analysis of online news reports (n = 192) from 2011 to 2019. News characteristics such as name and type of publication, language, location, slant and beat coverage, visuals, and administrative focus were quantified. Similarly, news contents were inductively coded to examine dominant themes and the implementation landscape. We found that coverage was initially low but increased after 2016. Overall, news reports were in favor of the ban. Five leading English newspapers covered the majority of the ban enforcement reports. Prominent themes like consumption, health hazards, tobacco control responses, impact on livelihoods, and illicit trade were drawn from the textual analysis as the main arguments in relation to the ban. Gutka is largely seen as an issue of crime reflected by the contents, sources, and frequent use of pictures depicting law enforcement. The interconnected distribution channels of the gutka industry hindered enforcement, highlighting the need to study the complexities of regional and local SLT supply chains.
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Affiliation(s)
- Vivek Dsouza
- Chronic Conditions and Public Policies cluster, Institute of Public Health Bengaluru (IPH), Karnataka, India
| | - Pratiksha Mohan Kembhavi
- Chronic Conditions and Public Policies cluster, Institute of Public Health Bengaluru (IPH), Karnataka, India
| | - Praveen Rao S
- Chronic Conditions and Public Policies cluster, Institute of Public Health Bengaluru (IPH), Karnataka, India
| | - Kumaran P
- Chronic Conditions and Public Policies cluster, Institute of Public Health Bengaluru (IPH), Karnataka, India
| | - Pragati B Hebbar
- Chronic Conditions and Public Policies cluster, Institute of Public Health Bengaluru (IPH), Karnataka, India
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
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Siddiqi K, Arora M, Gupta PC. Common assumptions in tobacco control that may not hold true for South-East Asia. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 8:100088. [PMID: 36644450 PMCID: PMC9831008 DOI: 10.1016/j.lansea.2022.100088] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Tobacco is a threat to public health in South-East Asia and its control should be a priority. However, many common assumptions about tobacco control may not hold true for the region and can misdirect policy. The substantial health risks associated with smokeless tobacco have been largely misunderstood and neglected. The syndemic association between tuberculosis and tobacco has also been overlooked. Similarly, less attention has been paid to address second-hand smoke exposure of pregnant women to indoor smoking (caused predominantly by men). On the other hand, our poor understanding of the diverse tobacco supply chain has been blocking progress in tobacco control. Finally, the rising popularity of electronic cigarettes has thrown new challenges; many governments, concerned for its youth, have banned such products. We argue for a nuanced approach to tobacco control in South-East Asia. We also encourage a wider debate in public health, where other established assumptions may be hampering progress.
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Affiliation(s)
- Kamran Siddiqi
- Department of Health Sciences, University of York and Hull York Medical School, Seebohm Rowntree building, University of York, York YO10 5DD, United Kingdom
| | - Monika Arora
- HRIDAY, New Delhi, and Public Health Foundation of India, New Delhi, India
| | - Prakash C Gupta
- Healis Sekhsaria Institute for Public Health, Thane, Maharashtra, India
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Islam MM. Hardcore use of smoked and smokeless tobacco products among men and women in Bangladesh: data from two rounds of the global adult tobacco survey. J Ethn Subst Abuse 2022:1-13. [PMID: 36409782 DOI: 10.1080/15332640.2022.2148150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study examines the prevalence of and factors associated with "hardcore" use of smoked and smokeless tobacco (SLT) products in Bangladesh and the variation in the ages people started using them daily. Data from the 2009 and 2017 rounds of the Global Adult Tobacco Survey for Bangladesh were analyzed using multilevel logistic regression. The prevalence of "hardcore" use of smoked tobacco among current smokers decreased from 15.5% in 2009 to 13.1% in 2017. Almost all hardcore smokers were male in both rounds. Among the current users of SLT, 7.0% were "hardcore" users in 2009, with a higher proportion of females (8.9%) than males (4.8%) and these percentages remained similar in 2017. The current smokers in the age-group 25-64 and the current SLT users in the age-group 45-65+ were more likely than their counterparts to be "hardcore" users. The earlier the participants started using daily, the more likely they were to become "hardcore" users. There was regional variation in the prevalence of "hardcore" use. Coordinated preventive interventions and comprehensive treatment programmes and their equitable geographical distribution are needed.
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Affiliation(s)
- M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Australia
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Islam MM. Comparison between Smokers and Smokeless Tobacco Users in Their Past Attempts and Intentions to Quit: Analysis of Two Rounds of a National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13662. [PMID: 36294241 PMCID: PMC9603089 DOI: 10.3390/ijerph192013662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
This study compares current tobacco smokers and smokeless tobacco (SLT) users in terms of their past quitting attempts and intentions to quit in the future, and identifies approaches used in their recent quitting attempts. Data (n = 14,498) of current tobacco users from two rounds of the Global Adult Tobacco Survey Bangladesh were analysed. Poisson regressions with robust variance were used to examine associations between the study factor and the two outcome variables. About half of smokers and a quarter of SLT users tried to quit during the 12 months before the survey. About two-thirds of smokers and half of SLT users intended to quit in the future. Smokers were more likely (adjusted prevalence ratio (aPR): 1.38, 95%CI: 1.24-1.53) than SLT users to have attempted to quit during the 12 months before the survey and to intend to quit in the future (aPR: 1.09, 95%CI: 1.02-1.16). The corresponding aPRs were even higher for dual users (smoked tobacco and used SLT). Future intention to quit for both smokers (aPR: 1.45, 95%CI: 1.38-1.53) and SLT users (aPR: 1.87, 95%CI: 1.76-1.98) was significantly associated with their past quitting attempts. Most of those who had attempted to quit did not receive any treatment. Proactive and tailored interventions to promote quitting and expansion of tobacco cessation methods are recommended.
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Affiliation(s)
- M Mofizul Islam
- Department of Public Health, Room 410, Health Sciences Building 2, La Trobe University, Bundoora, VIC 3086, Australia
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Islam MM. Daily users of both smoked and smokeless tobacco and their efforts to quit. JOURNAL OF SUBSTANCE USE 2022. [DOI: 10.1080/14659891.2022.2120434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- M. Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Australia
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