DOI QR코드

DOI QR Code

Trends of Smokeless Tobacco use among Adults (Aged 15-49 Years) in Bangladesh, India and Nepal

  • Sinha, Dhirendra N (Tobacco Free Initiative Unit, Regional Office for South-East Asia, World Health Organization) ;
  • Rizwan, SA (Department of Community Medicine, Velammal Medical College Hospital and Research Institute) ;
  • Aryal, Krishna K (Nepal Health Research Council) ;
  • Karki, Khem B (Nepal Health Research Council) ;
  • Zaman, Mostafa M (NPO-NCD, World Health Organization) ;
  • Gupta, Prakash C (Healis - Sekhsaria Institute for Public Health)
  • Published : 2015.10.06

Abstract

Background: Smokeless tobacco (SLT) has long been realized as an important component of the fight for global tobacco control. It still remains a major problem in countries like India, Bangladesh and Nepal. The objective of this study was to estimate the trends of SLT use in three countries of the SEARO WHO office. Materials and Methods: We used data from national surveys in three countries (Bangladesh, India and Nepal) to estimate trends in prevalence of current SLT use. All available nationally representative data sources were used. Estimates were weighted, age standardized and given along with 95% confidence intervals. Significance of linear trend in prevalence over time was tested using the Cochrane-Armitage test for trend. A p value of less than 0.05 was considered statistically significant. Results: We identified three surveys for Bangladesh, three for India and four for Nepal that met the selection criteria (such as Demographic and Health Surveys, WHO-STEPwise approach to Surveillance and Global Adult Tobacco Surveys). A significantly increasing trend was noticed in the prevalence of current SLT use among Bangladeshi men (20.2% to 23%, p=0.03). In India, a similar significantly increasing trend was seen among men (27.1% to 33.4%, p<0.001) and women (10.1% to 15.7%, p<0.001). In Nepal, there was a no significant trend among both men (39.1% to 31.6%, p=0.11) and women (5.6% to 4.7%, p=0.49). Conclusions: In the study countries SLT use has remained at alarmingly high levels. Usage trends do not show any signs of decline in spite of control efforts. Tobacco control measures should focus more on controlling SLT use.

Keywords

National surveys;smokeless tobacco;South-East Asia;trend;prevalence

References

  1. Ahmad OB, Boschi-Pinto C, Lopez AD, et al (2001). Age standardization of rates: a new WHO standard (WHO). GPE discussion paper series: No.31. World Health Organization. Geneva.
  2. Ansara DL, Arnold F, Kishor S, Hsia J, Kaufmann R (2013). Tobacco use by men and women in 49 countries with demographic and health surveys. DHS comparative reports no. 31. calverton, Maryland, USA: ICF international.
  3. Bhattacharyya N (2012). Trends in the use of smokeless tobacco in united states, 2000-2010. Laryngoscope, 122, 2175-8. https://doi.org/10.1002/lary.23448
  4. Bhawna G (2013). Burden of smoked and smokeless tobacco consumption in India - results from the global adult tobacco survey India (GATS-India)- 2009-201. Asian Pac J Cancer Prev, 14, 3323-9. https://doi.org/10.7314/APJCP.2013.14.5.3323
  5. Carr AB and Ebbert JO (2007). Interventions for tobacco cessation in the dental setting. A systematic review. Community Dent Health, 24, 70-4.
  6. Centers for Disease Control and Prevention (CDC) (2011). Global adult tobacco survey collaborative group. tobacco questions for surveys: a subset of key questions from the global adult tobacco survey (GATS), 2nd Edition. Atlanta, GA.
  7. Danawala SA, Arora M, and Stigler MH (2014). Analysis of motivating factors for smokeless tobacco use in two Indian states. Asian Pac J Cancer Prev, 15, 6553-8. https://doi.org/10.7314/APJCP.2014.15.16.6553
  8. Dave D and Saffer H (2013). Demand for smokeless tobacco: role of advertising. J Health Econ, 32, 682-7. https://doi.org/10.1016/j.jhealeco.2013.03.007
  9. Ebbert JO, Montori V, Vickers KS, et al. (2007). Interventions for smokeless tobacco use cessation. Cochrane Database Syst Rev, 4306.
  10. Eriksen M, Mackay J and Ross H (2012). The tobacco atlas. 4th ed. Atlanta: American Cancer Society; New York.
  11. European Commission (EC) (2008). Scientific committee on emerging and newly identified health risks. Health effects of smokeless tobacco products. Brussels.
  12. Gajalakshmi V, and Kanimozhi V (2015). Tobacco chewing and adult mortality: a case-control analysis of 22,000 cases and 429,000 controls, never smoking tobacco and never drinking alcohol, in South India. Asian Pac J Cancer Prev, 16, 1201-6. https://doi.org/10.7314/APJCP.2015.16.3.1201
  13. International Agency for Research on Cancer (IARC) (2007). Smokeless tobacco and some tobacco-specific N-nitrosamines. IARC monographs on the evaluation of carcinogenic risks to humans. Vol. 89. Lyon, France.
  14. ITC Project (ITCP) (2013). TCP India National Report. Findings from the Wave 1 Survey (2010-2011). University of waterloo, waterloo, ontario, canada; healis-sekhsaria institute for public health, Navi Mumbai, India.
  15. ITC Project (ITCP) (2014). Tobacco price and taxation policies in bangladesh: evidence of effectiveness and implications for action. University of Waterloo, Waterloo, Ontario, Canada.
  16. Mahato P (2012). Current tobacco control practices in Nepal: existing gaps and way forward. JHAS, 2, 70-3.
  17. Mini GK, Sarma PS, and Thankappan KR (2014). Pattern of tobacco use and its correlates among older adults in India. Asian Pac J Cancer Prev, 15, 6195-8. https://doi.org/10.7314/APJCP.2014.15.15.6195
  18. Nargis N, Hussain AKMG and Fong GT (2014). Smokeless tobacco product prices and taxation in Bangladesh: findings from the international tobacco control survey. Indian J Cancer, 51, 33-8. https://doi.org/10.4103/0019-509X.151994
  19. National Cancer Institute (NCI) and Centers for Disease Control and Prevention (CDC) (2014). Smokeless tobacco and public health: a global perspective. Bethesda, MD: U.S. department of health and human services, centers for disease control and prevention and national institutes of health, national cancer institute. NIH Publication No. 14-7983.
  20. Ng M, Freeman MK, Fleming TD, et al. (2014). Smoking prevalence and cigarette consumption in 187 countries, 1980-2012. JAMA, 311, 183-2. https://doi.org/10.1001/jama.2013.284692
  21. Norberg M, Malmberg G, Ng N, and Brostrom G (2011). Who is using snus? - Time trends, socioeconomic and geographic characteristics of snus users in the ageing Swedish population. BMC Public Health, 11, 929. https://doi.org/10.1186/1471-2458-11-929
  22. Palipudi KM, Sinha DN, Choudhury S, et al (2012). Predictors of tobacco smoking and smokeless tobacco use among adults in Bangladesh. Indian J Cancer, 49, 387-2. https://doi.org/10.4103/0019-509X.107745
  23. Panda R, Persai D, Mathur M, and Sarkar BK (2013). Perception and practices of physicians in addressing the smokeless tobacco epidemic: findings from two States in India. Asian Pac J Cancer Prev, 14, 7237-1. https://doi.org/10.7314/APJCP.2013.14.12.7237
  24. Piano MR, Benowitz NL, Fitzgerald GA, et al (2010). Impact of smokeless tobacco products on cardiovascular disease: implications for policy, prevention, and treatment: a policy statement from the American heart association. Circulation, 122, 1520-4. https://doi.org/10.1161/CIR.0b013e3181f432c3
  25. Rout SK, and Arora M (2014). Taxation of smokeless tobacco in India. Indian J Cancer, 51, 8-2.
  26. Severson HH (2003). What have we learned from 20 years of research on smokeless tobacco cessation? Am J Med Sci, 326, 206-1. https://doi.org/10.1097/00000441-200310000-00011
  27. Sinha DN, Palipudi KM, Jones CK, et al (2014). Levels and trends of smokeless tobacco use among youth in countries of the World Health Organization South-East Asia Region. Indian J Cancer, 51, 50-3.
  28. Thakur JS, Prinja S, Bhatnagar N, Rana S, and Sinha, DN (2013). Socioeconomic inequality in the prevalence of smoking and smokeless tobacco use in India. Asian Pac J Cancer Prev, 14, 6965-9. https://doi.org/10.7314/APJCP.2013.14.11.6965
  29. U.S. Department of Health and Human Services (USDHHS) (1986). The health consequences of using smokeless tobacco: a report of the advisory committee to the surgeon general. NIH publication no. 86-2674. Bethesda, MD.
  30. Wang Z and Ma J (2012). Prevalence and patterns of tobacco use in Asia. Lancet, 380, 1905-6.
  31. World Health Organization (WHO) (2011). WHO report on the global tobacco epidemic, 2011. Geneva.
  32. World Health Organization (WHO) (2013). Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Geneva.
  33. Zaman MM, Bhuiyan,MR, Huq SM, et al (2014). Dual use of tobacco among Bangladeshi men. Indian J Cancer, 51, 46-9. https://doi.org/10.4103/0019-509X.147481

Cited by

  1. Alcohol and economic development: Observations on the kingdom of Bhutan vol.36, pp.3, 2016, https://doi.org/10.1111/dar.12382
  2. Widowhood and Alcohol, Tobacco, and Other Drug Use Among Older Adults in India pp.1758-5368, 2016, https://doi.org/10.1093/geronb/gbw134
  3. Cytological and cytomorphometric characteristics of buccal mucosa cells from smokeless tobacco users vol.45, pp.11, 2017, https://doi.org/10.1002/dc.23803
  4. Smokeless tobacco-associated cancers: A systematic review and meta-analysis of Indian studies vol.138, pp.6, 2015, https://doi.org/10.1002/ijc.29884
  5. Smokeless Tobacco Use is “Replacing” the Smoking Epidemic in the South-East Asia Region pp.1469-994X, 2017, https://doi.org/10.1093/ntr/ntx272
  6. Assessment of Tobacco Consumption and Control in India vol.9, pp.1179-9161, 2018, https://doi.org/10.1177/1179916118759289
  7. A nationally representative study on socio-demographic and geographic correlates, and trends in tobacco use in Nepal vol.9, pp.1, 2019, https://doi.org/10.1038/s41598-019-39635-y