1
|
Czaplicki L, Saraf S, Kroart L, Rasheduzzaman ABM, Islam MS, Cohen JE. Standard smokeless tobacco packaging: potential impact on perceived attractiveness, warning label visibility and harm perceptions among adults in Bangladesh. Tob Control 2024; 33:353-359. [PMID: 36316153 DOI: 10.1136/tc-2022-057597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND In Bangladesh, smokeless tobacco (SLT) is available in a variety of pack shapes and sizes. Lack of standard packaging could limit compliance with pictorial health warning label (HWL) requirements. We explored Bangladeshi SLT users' and non-users' perceptions of a proposed standard pack shape for gul (tobacco powder) and zordha (chewing tobacco), including the role that HWL placement plays on harm perceptions. METHODS We conducted 28 focus groups across three regions of Bangladesh: Dhaka, Sylhet and Khulna. Groups were stratified equally by urban/rural residence, gender and SLT use. Trained facilitators used a standardised guide to discuss perceived attractiveness, noticeability of HWLs and perceived harm of current versus standard packs. RESULTS Most groups found bright colours, 'brand owner' portrait imagery, and strong, sturdy pack material of current packs attractive. Many of the same features increased perceived attractiveness of the standard packs. Pictorial HWLs on the standard packs appeared larger and increased the visibility and noticeability of HWLs compared with current packs. Lack of HWLs or limited visibility of HWL due to discolouration contributed to lower levels of perceived harm of the current packs. In contrast, HWL prominence and placement on both sides of the standard pack increased perceived harm of standard packs. CONCLUSION The findings suggest a standard shape and size for SLT sold in Bangladesh, coupled with proper implementation of HWLs per the law, could improve HWL noticeability and increase harm perceptions. Additional plain packaging policies that also standardise pack colour may be required to reduce attractive colours and branding.
Collapse
Affiliation(s)
- Lauren Czaplicki
- Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Sejal Saraf
- Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Laura Kroart
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
2
|
Banu B, Khan MMH, Ali L, Barnighausen T, Sauerborn R, Souares A. Pattern and predictors of non-adherence to diabetes self-management recommendations among patients in peripheral district of Bangladesh. Trop Med Int Health 2024; 29:233-242. [PMID: 38221661 DOI: 10.1111/tmi.13966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
OBJECTIVES This study was designed to determine the extent of non-adherence to the different dimensions of diabetes self-management and to identify the factors influencing non-adherence among peripheral patients in Bangladesh. METHODS A cross-sectional study was conducted among 990 adult diabetic patients residing in Thakurgaon district, Bangladesh. Data were collected through face-to-face interviews including socio-demographic information, disease and therapeutic, health services, knowledge and adherence to self-management components. RESULTS The proportion of non-adherence to drug prescription was 66.7%, dietary regimen (68.9%), physical exercise (58.0%), follow-up visit/blood glucose test (88.2%), stopping tobacco (50.6%), and regular foot care (93.9%). Significant predictors for non-adherence to drug were poorest socio-economic status (OR = 2.47), absence of diabetic complications (OR = 1.43), using non-clinical therapy (OR = 5.61), and moderate level of knowledge (OR = 1.87). Non-adherence to dietary recommendations was higher for women (OR = 1.72), poorest socio-economic status (OR = 3.17), and poor technical knowledge (OR = 4.68). Non-adherence to physical exercise was lower for women (OR = 0.62), combined family (OR = 0.63), middle socio-economic status (OR = 0.54), and moderate knowledge on physical exercise (OR = 0.55). Non-adherence to follow-up visits/blood glucose test was higher among patients who did not have diabetic complications (OR = 1.81) and with own transport (OR = 2.57), and respondents from high-income group (OR = 0.23) were less likely to be non-adherent. Non-adherence to stopping tobacco was higher for older individuals (OR = 1.86); but lower for women (OR = 0.48), individuals with higher education level (OR = 0.17) and patients sick for a longer time (OR = 0.52). Non-adherence to foot care was higher for patients who needed longer time to go to hospital (OR = 4.07) and had poor basic knowledge on diabetes (OR = 17.80). CONCLUSION An alarmingly high proportion of diabetic patients did not adhere to diabetes self-management. Major predictors for non-adherence were related to patient's demographic characteristics and their experience with disease, treatment and health care services.
Collapse
Affiliation(s)
- Bilkis Banu
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Department of Public Health, Northern University Bangladesh, Dhaka, Bangladesh
| | | | - Liaquat Ali
- Pothikrit Institute of Health Studies, Dhaka, Bangladesh
| | - Till Barnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
3
|
Dhanapriyanka M, Kanthi RDFC, Jayasekara P, Ha DH. Tobacco chewing and associated factors among a vulnerable youth population in Sri Lanka. BMC Public Health 2022; 22:2209. [PMID: 36443802 PMCID: PMC9706888 DOI: 10.1186/s12889-022-14704-6] [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: 05/26/2022] [Accepted: 11/22/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Tobacco in any form kills millions of people every year. Tobacco addiction among youth shows an increasing trend while smokeless type is becoming more common. This study aimed to describe the lifestyle of chewing smokeless tobacco among a group of high-risk youth population in Sri Lanka. METHODS A descriptive cross-sectional study was conducted among a sample of 1431 youths aged between 15 to 24 years residing in urban slums in Colombo Sri Lanka, using a cluster sampling technique combined with probability proportionate to size technique. Data were collected using an interviewer-administered questionnaire. Chewing smokeless tobacco was assessed using betel quid chewing and commercially prepared tobacco and areca nut packet chewing. Current chewer was defined as who had the practice of chewing during past 30 days. RESULTS The mean age of the study sample was 17.53 (95% CI: 17.40-17.65). Of the 1431 respondents, 57% were males and 43% were females. The prevalence of current smokeless tobacco chewers was 44.9% and among them 90.8% were males and 9.8% were females. Around 31.3% did not have smokeless tobacco chewing practice (Male-5.9%, Female-64.9%). Among the current smokeless tobacco chewers 21.5% chew both types of smokeless tobacco products and all of them were males. Male gender (OR 17.9; 11.4 -27.9) and ever smoking lifestyle (OR 4.4; 2.9-6.6) were significant determinants of current smokeless tobacco chewing lifestyle. CONCLUSION AND RECOMMENDATIONS The study shows a high prevalence of smokeless tobacco use by youth aged between 15 to 24 years who were residing in urban slum areas in the district of Colombo, in Sri Lanka, highlighting this target group for early intervention to reduce the uptake and promote the quitting of this practice.
Collapse
Affiliation(s)
| | | | | | - Diep Hong Ha
- School of Dentistry, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| |
Collapse
|
4
|
Nethan ST, Sinha DN, Kedar A, Kumar V, Sharma S, Hariprasad R, Mehrotra R. Tobacco use among urban slum dwellers attending a cancer screening clinic in the National Capital Region of India: a cross-sectional study. Ecancermedicalscience 2021; 15:1230. [PMID: 34158834 PMCID: PMC8183651 DOI: 10.3332/ecancer.2021.1230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Indexed: 12/02/2022] Open
Abstract
Background Tobacco consumption in India varies based on the place of residence (urban/rural). Minimal, exclusive information exists regarding the same for ‘urban slum’ dwellers. The current study determines the tobacco use pattern among such individuals in Noida, Uttar Pradesh (India). Methods A cross-sectional study was conducted among the urban slum residents visiting the institutional clinic between December 2016 and June 2019. Apart from tobacco history, routine recording of the basic demographic details and oral visual examination was carried out for the participants. For categorical data, the percentage of different parameters was calculated and for quantitative data, descriptive statistics were calculated. Chi-square or Fisher’s exact tests were employed to determine the association between the two categorical variables. To find the strength of association between tobacco use and the socio-demographic factors, univariate and multivariable binary logistic regression was used. Results Among 2,043 urban slum respondents (602 male, 1441 female), 15.0% (n = 308) currently consumed tobacco. The majority were smokeless tobacco (SLT) users (among both males and females). Among males, khaini (42.1%) and gutkha (32.5%) and among females gul (36.1%) were the most widely used tobacco products. Conclusion The majority of the Noida urban slum population attending the screening clinic consumed SLT. Gender variation in the tobacco form and product-specific consumption patterns indicates that the undertaking of urban slums-specific surveys is essential. Tobacco control programmes must incorporate appropriate strategies addressing such subgroups of tobacco users.
Collapse
Affiliation(s)
- Suzanne T Nethan
- School of Preventive Oncology, A/27, Anandpuri, West Boring Canal Road, Patna 800001, India
| | - Dhirendra N Sinha
- School of Preventive Oncology, A/27, Anandpuri, West Boring Canal Road, Patna 800001, India
| | - Ashwini Kedar
- National Viral Hepatitis Control Program, Ministry of Health & Family Welfare, Nirman Bhawan, Near Udyog Bhawan Metro Station, Maulana Azad Rd, Delhi 110011, India
| | - Vipin Kumar
- Nippon Data System Ltd., B-14, Sector 8, Noida 201301, India
| | - Shashi Sharma
- Senior Biostatistician, C58/25, B902, Jagdamba Apartments, Sector 62, Noida 201307, India
| | - Roopa Hariprasad
- Division of Clinical Oncology, Indian Council of Medical Research-National Institute of Cancer Prevention & Research (ICMR-NICPR), I-7 Sector 39, Noida 201301, India
| | - Ravi Mehrotra
- Chief Executive Officer, ICMR - India Cancer Research Consortium, IRCS Building, Red Cross Road, Delhi 110003, India
| |
Collapse
|
5
|
Anwar N, Pervez S, Chundriger Q, Awan S, Moatter T, Ali TS. Oral cancer: Clinicopathological features and associated risk factors in a high risk population presenting to a major tertiary care center in Pakistan. PLoS One 2020; 15:e0236359. [PMID: 32760151 PMCID: PMC7410283 DOI: 10.1371/journal.pone.0236359] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 07/03/2020] [Indexed: 12/19/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) has the highest prevalence in head and neck cancers and is the first and second most common cancer in males and females of Pakistan respectively. Major risk factors include peculiar chewing habits like areca nut, betel quid, and tobacco. The majority of OSCC presents at an advanced stage with poor prognosis. On the face of such a high burden of this preventable cancer, there is a relative lack of recent robust data and its association with known risk factors from Pakistan. The aim of this study was to identify the socioeconomic factors and clinicopathological features that may contribute to the development of OSCC. A total of 186 patients diagnosed and treated at a tertiary care hospital, Karachi Pakistan were recruited. Clinicopathological and socioeconomic information was obtained on a structured questionnaire. Descriptive analysis was done for demographics and socioeconomic status (SES) while regression analysis was performed to evaluate the association between SES and chewing habits, tumor site, and tumor stage. The majority of patients were males and the mean age of OSCC patients was 47.62±12.18 years. Most of the patients belonged to low SES (68.3%) and 77.4% were habitual of chewing. Gender (male) and SES were significantly associated with chewing habits (p<0.05). Odds of developing buccal mucosa tumors in chewers (of any type of substance) and gutka users were 2 and 4 times higher than non-chewers respectively. Middle age, chewing habits, and occupation were significantly associated with late stage presentation of OSCC (p<0.05). In conclusion, male patients belonging to low SES in their forties who had chewing habits for years constituted the bulk of OSCC. Buccal mucosa was the most common site in chewers and the majority presented with late stage tumors.
Collapse
Affiliation(s)
- Namrah Anwar
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Shahid Pervez
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Qurratulain Chundriger
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Sohail Awan
- Department of Otolaryngology, Head and Neck Surgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Tariq Moatter
- Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Tazeen Saeed Ali
- School of Nursing and Midwifery, Aga Khan University Hospital, Karachi, Pakistan
- * E-mail:
| |
Collapse
|
6
|
Yasmin F, Nahar N, Banu B, Ali L, Sauerborn R, Souares A. The influence of mobile phone-based health reminders on patient adherence to medications and healthy lifestyle recommendations for effective management of diabetes type 2: a randomized control trial in Dhaka, Bangladesh. BMC Health Serv Res 2020; 20:520. [PMID: 32513164 PMCID: PMC7282058 DOI: 10.1186/s12913-020-05387-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/01/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In 2017, 80% of 425 million adults with diabetes worldwide were living in low and middle-income countries. Diabetes affected 6.9 million adults in Bangladesh and accounted for 3% of the country's total mortality. Proper management of diabetes is the key to positive health outcomes. This study investigated how mobile phone-based health intervention could increase patient adherence and thereby improve the disease outcomes for diabetes type 2 in Bangladesh. METHODS A mobile phone-based health project (including mobile phone reminders and 24/7 call center) was implemented in Dhaka District, Bangladesh from January to December 2014. A randomized control trial was carried out, recruiting randomly in intervention and control groups among the patients receiving treatment for type 2 diabetes at the Bangladesh Institute of Health Sciences Hospital, Dhaka, Bangladesh. A total of 320 patients from both groups at baseline and 273 at endline were interviewed. RESULTS A significant improvement in patient adherence to diet, physical exercise, the cessation of use of tobacco and betel nut, and blood glycaemic control was found in the intervention group, whereas no such significant improvement was found in the control group. Cost and other co-morbidities were found to be the main reasons for non-adherence. CONCLUSION A mobile-health intervention should be considered as an additional option for non-communicable disease programs.
Collapse
Affiliation(s)
- Farzana Yasmin
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany.
- Friede Springer Endowed Professorship for Global Child Health, Faculty of Health/Department of Human Medicine, University of Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Germany.
| | | | - Bilkis Banu
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Liaquat Ali
- Pothikrit Institute of Health Studies, Dhaka, Bangladesh
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health (HIGH), Heidelberg University Hospital, Heidelberg, Germany
| |
Collapse
|
7
|
Haque MI, Chowdhury ABMA, Hassan MS, Khan HTA, Harun MGD. Prevailing familial, social and cultural obstacles in keeping tobacco-free homes in urban areas of Bangladesh: A mixed-method study. PLoS One 2019; 14:e0220777. [PMID: 31404115 PMCID: PMC6690649 DOI: 10.1371/journal.pone.0220777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/23/2019] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Millions of children and others across the world are being dangerously exposed to tobacco smoke and toxins in their own homes. Whilst there is limited interest in laws and interventions controlling tobacco use in public places in Bangladesh, no attention has been given to preventing tobacco-use inside homes. This study explores the familial and socio-cultural factors that provide obstacles for ensuring tobacco-free homes in Bangladesh. MATERIALS AND METHODS A mixed-method design was adopted and from among the 1,436 tobacco users identified in a population of 11,853, 400 (tobacco users) were selected for cross-sectional survey. This survey involved a probability proportional sampling procedure, and 24 In-Depth Interviews. Multivariate logistic regression was performed to explore the association of familial and socio-cultural factors with tobacco-use at home adjusted by other demographic characteristics. Thematic content analysis was done on the qualitative data, and then inferences were drawn out collectively. RESULTS This study revealed that the prevalence of tobacco-use in the home was 25.7% in urban residential areas in Bangladesh. Multivariate logistic regression analysis identified that familial and socio-cultural factors were significantly associated with tobacco-use at home: marital status (OR 3.23, 95% CI: 1.37-6.61), education (OR 2.14, 95% CI: 1.15-3.99), smoking habits of older family members (OR 1.81 95% CI: 0.91-2.89), tobacco being offered as hospitality and for entertainment (OR 1.85, 95% CI: .94-2.95) and lack of religiosity practice (OR 2.39, 95% CI: 1.27-4.54). Qualitative findings indicated that social customs, lack of religious practice, tobacco-use of older family members, and lack of family guidance were key obstacles for enabling tobacco-free homes in urban areas. CONCLUSION Use of tobacco at home is continuing as part of established familial and socio-cultural traditions. If tobacco-use at home is not addressed seriously by the authorities then the emerging threat of second-hand smoke exposure and harmful consequences of tobacco- use will be exacerbated.
Collapse
Affiliation(s)
- Md. Imdadul Haque
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhanmondi, Dhaka, Bangladesh
- * E-mail:
| | - ABM Alauddin Chowdhury
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhanmondi, Dhaka, Bangladesh
| | - Muhammad Shaikh Hassan
- Center of Excellence for Health Systems and Universal Health Coverage, BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Hafiz T. A. Khan
- The Graduate School, University of West London, London, United Kingdom
| | - Md. Golam Dostogir Harun
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhanmondi, Dhaka, Bangladesh
| |
Collapse
|
8
|
Sharma A, Gupta SK, Agrawal S, Gupta SK, Sarouthia S. A Health Education Intervention Study on Tobacco Consumption Among the Urban Slum Residents of Central India. Int J Prev Med 2019; 10:96. [PMID: 31360343 PMCID: PMC6592133 DOI: 10.4103/ijpvm.ijpvm_141_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Accepted: 09/01/2018] [Indexed: 12/05/2022] Open
Abstract
Background: Tobacco is one of the world's leading avoidable causes of premature death, disease, and disability. According to the World Health Organization (WHO) survey 2020, there are about 120 million tobacco users in India, and WHO estimates that about 4.9 million die due to tobacco annually, and that by 2020 it will be the principal cause of death and disability. This study is done with objectives to access the prevalence of tobacco consumption, evaluate the impact of health education and intervention. Methods: It was community-based health educational interventional study conducted in urban slum setting in Bhopal India, comprising 1598 subjects, and out of these 520 participants were assessed for final outcome with 3 months study duration. A predesigned, pretested questionnaire proforma was developed containing the study variables including socio-demographic, education, age, occupation, type of tobacco product consumed and so on and distributed to all study participants in pre-interventional phase and only in tobacco consumers of post-interventional phase and then was finally evaluated. Results: The prevalence of tobacco use was 32.50% among the tobacco user; 87% were males and rest were females. In post-interventional phase there was a significant difference (P < 0.0001) observed in tobacco consumption frequency, impact of staring with criticism, condemnation, denigration and total number of tobacco quitter. Conclusion: After the health educational interventional motivation, majority of users are ready to quit, so we have to help them in quitting which must include the effectual intervention to control the tobacco use by making an effective strong policy by increasing their knowledge by means of IEC and health education.
Collapse
Affiliation(s)
- Anshuman Sharma
- Department of Community Medicine, Shyam Shah Medical College, Rewa, Madhya Pradesh, India
| | - Sanjeev Kumar Gupta
- Department of Community Medicine, RKDF Medical College and RC, Jatkhedi, Bhopal, Madhya Pradesh, India
| | - Sanjay Agrawal
- Department of Community Medicine, R D Gardi Medical College, Ujjain, Madhya Pradesh, India
| | - Sanjay Kumar Gupta
- Department of Community Medicine, Peoples College of Medical Science and RC, Bhopal, Madhya Pradesh, India
| | - Shalini Sarouthia
- Department of Community Medicine, RKDF Medical College and RC, Jatkhedi, Bhopal, Madhya Pradesh, India
| |
Collapse
|
9
|
Ullah MZ, Lim JN, Ha MA, Rahman MM. Smokeless tobacco use: pattern of use, knowledge and perceptions among rural Bangladeshi adolescents. PeerJ 2018; 6:e5463. [PMID: 30155362 PMCID: PMC6108312 DOI: 10.7717/peerj.5463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 07/26/2018] [Indexed: 02/03/2023] Open
Abstract
Background The aim of the study was to investigate the practice and pattern of smokeless tobacco (SLT) use as well as the knowledge and perception about its ill effects among rural Bangladeshi adolescents. Methods A cross-sectional survey was conducted among students aged 13-18 years in two rural secondary schools in Bangladesh in August 2015. Data were collected through a self-administered questionnaire which consists of topics derived from the Social Cognitive Theory and Health Belief Model (personal characteristics, environmental factors, self-efficacy, outcome expectancies, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action). Data analysis was performed using SPSS version 24. A descriptive analysis was conducted to determine the current pattern of SLT use and knowledge about its ill effects. A chi-square test and Fisher exact test were conducted to explore associations between variables. Lastly, a logistic regression model was used to locate the predictors for current SLT use. Results A total of 790 students participated in the study. Among them, 9.5% (75) had used SLT at least once and 3.7% (29) were current SLT users. Males had a higher incidence of SLT use compared with females. The majority of students (77.3%) initiated SLT use between 10-13 years of age. 'Zarda' was the most common type of SLT used and most of the current users (86%) were able to buy SLT without age restrictions. Most of the current users (90%) wanted to quit SLT immediately; however, professional help was not available in schools. Overall, students had a good knowledge about the harmful effects of SLT with 54.8% (428) of respondents scoring in the good knowledge category. However, the majority of never SLT users (55.4%; 396) had a good knowledge compared to ever SLT users (42.7%; 32). Significant predictors of current SLT use included being a student aged 14 years and above (OR = 6.58, 95% CI [2.23-28.31]) as well as the variables of self-efficacy (OR = 5.78, 95% CI [1.46-19.65]), perceived barriers (OR = 0.30, 95% CI [0.10-0.74]), perceived benefit (OR = 0.21, 95% CI [0.05-1.03]) and perceived severity (OR = 0.36, 95% CI [0.16-0.91]). Discussion This study demonstrates the need for comprehensive prevention and control programme in rural schools targeting young adolescents. Effective measure should be taken to reshape the attitude of rural adolescents towards self-confidence and competence, as to prevent SLT use.
Collapse
Affiliation(s)
- Md Zahid Ullah
- Faculty of Medical Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Jennifer Nw Lim
- Faculty of Education, Work and Health, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Marie-Ann Ha
- Faculty of Medical Science, Anglia Ruskin University, Cambridge, United Kingdom
| | - Md Mostafizur Rahman
- Department of Oral Surgery, Dhaka Dental College and Hospital, Dhaka, Bangladesh
| |
Collapse
|
10
|
Mia MN, Hanifi SMA, Rahman MS, Sultana A, Hoque S, Bhuiya A. Prevalence, pattern and sociodemographic differentials in smokeless tobacco consumption in Bangladesh: evidence from a population-based cross-sectional study in Chakaria. BMJ Open 2017; 7:e012765. [PMID: 28122830 PMCID: PMC5278241 DOI: 10.1136/bmjopen-2016-012765] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The health hazards associated with the use of smokeless tobacco (SLT) are similar to those of smoking. However, unlike smoking, limited initiatives have been taken to control the use of SLT, despite its widespread use in South and Southeast Asian countries including Bangladesh. It is therefore important to examine the prevalence of SLT use and its social determinants for designing appropriate strategies and programmes to control its use. OBJECTIVE To investigate the use of SLT in terms of prevalence, pattern and sociodemographic differentials in a rural area of Bangladesh. DESIGN Population-based cross-sectional household survey. SETTING AND PARTICIPANTS A total of 6178 individuals aged ≥13 years from 1753 households under the Chakaria HDSS area were interviewed during October-November 2011. METHODS The current use of SLT, namely sadapatha (dried tobacco leaves) and zarda (industrially processed leaves), was used as the outcome variable. The crude and net associations between the sociodemographic characteristics of respondents and the outcome variables were examined using cross-tabular and multivariable logistic regression analysis, respectively. RESULTS 23% of the total respondents (men: 27.0%, women: 19.3%) used any form of SLT. Of the respondents, 10.4% used only sadapatha,13.6% used only zarda and 2.2% used both. SLT use was significantly higher among men, older people, illiterate, ever married, day labourers and relatively poorer respondents. The odds of being a sadapatha user were 3.5-fold greater for women than for men and the odds of being a zarda user were 3.6-fold greater for men than for women. CONCLUSIONS The prevalence of SLT use was high in the study area and was higher among socioeconomically disadvantaged groups. The limitation of the existing regulatory measures for controlling the use of non-industrial SLT products should be understood and discussion for developing new strategies should be a priority.
Collapse
Affiliation(s)
- Mohammad Nahid Mia
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - S M A Hanifi
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - M Shafiqur Rahman
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Amena Sultana
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Shahidul Hoque
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Abbas Bhuiya
- Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
- Future Institute, Dhaka, Bangladesh
| |
Collapse
|