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Naznin E, George J, Driezen P, Palazzi K, Wynne O, Nargis N, Fong GT, Bonevski B. Trend over time on knowledge of the health effects of cigarette smoking and smokeless tobacco use in Bangladesh: Findings from the International Tobacco Control Policy Evaluation Bangladesh Surveys. Drug Alcohol Rev 2023; 42:1838-1849. [PMID: 37565295 PMCID: PMC11031133 DOI: 10.1111/dar.13735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 07/04/2023] [Accepted: 07/26/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Cigarette smoking and smokeless tobacco (ST) use are prevalent in Bangladesh. This longitudinal study examined how knowledge of the health effects of smoking and ST use in Bangladesh has changed overtime with the country's acceleration of tobacco control efforts. METHODS Data were analysed from the International Tobacco Control Survey, a nationally representative longitudinal study of users and non-users of tobacco (aged 15 and older) in Bangladesh, across four waves conducted in 2009 (n = 4378), 2010 (n = 4359), 2012 (n = 4223) and 2015 (n = 4242). Generalised estimating equations assessed the level of knowledge about harms of tobacco use across four waves. Multivariable logistic regressions assessed whether knowledge of health effects from cigarette smoking and ST use in 2015 differed by user group. RESULTS In 2015 survey, most tobacco users were aware that cigarette smoking causes stroke (92%), lung cancer (97%), pulmonary tuberculosis (97%) and ST use causes mouth cancer (97%) and difficulty in opening mouth (80%). There were significant increases in the total knowledge score of smoking related health harm from 2010 to 2012 (mean difference = 0.640; 95% confidence interval [CI] 0.537, 0.742) and 2012 to 2015 (mean difference = 0.555; 95% CI 0.465, 0.645). Participants had greater odds of awareness for ST health effects from 2010 to 2015. DISCUSSION AND CONCLUSIONS The results suggest that increasing efforts of awareness policy interventions is having a positive effect on tobacco-related knowledge in Bangladesh. These policy initiatives should be continued to identify optimal methods to facilitate behaviour change and improve cessation of smoking and ST use.
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Affiliation(s)
- Eva Naznin
- Research higher degree, School of Medicine and Public Health, The University of Newcastle, University Drive Callaghan, NSW 2308, Australia
| | - Johnson George
- Senior lecturer, Centre for Medicine Use and Safety, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia
| | - Pete Driezen
- Research Assistant Professor, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Kerrin Palazzi
- Senior Statistician, Hunter Medical Research Institute (HMRI), Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Olivia Wynne
- Health Research Economist, Hunter Medical Research Institute (HMRI), Lot 1, Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Nigar Nargis
- Senior Scientific Director, Surveillance and Healthy Equity Science. American Cancer Society, 555 11th Street NW suite 300, Washington DC, 20004
| | - Geoffrey T. Fong
- Professor, School of Public Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Billie Bonevski
- Professor and Lead of Public Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Sturt Road, Bedford Park, Adelaide 5042, Australia
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Naznin E, Wynne O, George J, Denham AMJ, Hoque ME, Milton AH, Bonevski B, Stewart K. Smokeless tobacco policy in Bangladesh: A stakeholder study of compatibility with the World Health Organization's Framework Convention on Tobacco Control. Drug Alcohol Rev 2021; 40:856-863. [PMID: 33470003 DOI: 10.1111/dar.13243] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 11/04/2020] [Accepted: 12/15/2020] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Smokeless tobacco (ST) is the predominant form of tobacco used in Bangladesh and is associated with adverse health outcomes. Bangladesh ratified the World Health Organization's Framework Convention on Tobacco Control (FCTC) in 2004. There are concerns that FCTC legislation and implementation of ST control policy is insufficient in Bangladesh. The aim of this study was to investigate the achievements and challenges of ST policy in Bangladesh and its alignment with the FCTC. METHODS We conducted semi-structured key informant interviews with 20 stakeholders from government and non-government offices and international funding agencies, including tobacco control advocates, policy makers and non-governmental organisation workers. We used NVivo software to create key themes and the framework method for thematic analysis. RESULTS Our findings revealed a lack of national policy in terms of disclosure of harmful contents, illicit trade and standardised packaging of ST. Legislation remains ineffective in relation to graphical health warnings and tax measures. Challenges to ST control identified included inadequate law enforcement; paucity of research, surveillance, and evidence generation; and supply chain control. We identified lack of congruence of ST policies with FCTC due to slow progress in implementation of FCTC measures, lack of a country-specific policy and industry interference. To comply with FCTC, participants recommended strong leadership and political commitment, co-ordination between public and private sectors and proper use of tobacco control resources. DISCUSSION AND CONCLUSIONS Bangladesh has adopted several important FCTC measures, but further strengthening of ST policy is needed to enable full implementation of FCTC.
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Affiliation(s)
- Eva Naznin
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Olivia Wynne
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Johnson George
- Centre for Medicine Use and Safety, Monash University, Melbourne, Australia
| | - Alexandra M J Denham
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
- Priority Research Centre for Stroke and Brain Injury, Hunter Medical Research Institute, Newcastle, Australia
| | - Mohammad E Hoque
- Institute For Social Science Research, The University of Queensland, Brisbane, Australia
| | - Abul H Milton
- Department of Public Health, Northern University, Dhaka, Bangladesh
| | - Billie Bonevski
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia
| | - Kay Stewart
- Centre for Medicine Use and Safety, Monash University, Melbourne, Australia
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Naznin E, Wynne O, George J, Hoque ME, Milton AH, Bonevski B. Systematic review and meta-analysis of the prevalence of smokeless tobacco consumption among adults in Bangladesh, India and Myanmar. Trop Med Int Health 2020; 25:774-789. [PMID: 32358906 DOI: 10.1111/tmi.13410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To estimate the pooled prevalence of smokeless tobacco consumption (STC) by gender and location in Bangladesh, India and Myanmar and to identify periodic changes in STC prevalence using data extracted from published studies. METHODS We searched for a combination of keywords in electronic databases and used a standard form to extract data from each article. We undertook a meta-analysis to estimate pooled prevalence and confidence intervals within these countries. To compare periodic changes in STC prevalence, we grouped studies into five-year periods (2000-2004, 2005-2009, 2010-2014 and 2015-2019). RESULTS The pooled estimates of STC prevalence were 25% (95% CI: 22-28%), 22% (95% CI: 15-28%) and 21% (95% CI: 14-28%) for Bangladesh, India and Myanmar, respectively. In pooled estimates across these countries, we found higher STC prevalence for men (30%; 95% CI: 24-35%) than women (16%; 95% CI: 10-23%) and for rural dwellings (24%; 95% CI: 18-31%) than urban dwellings (17%; 95% CI: 10-24%). We found significant decrease in STC in Bangladesh and India in the period 2010-2014 and 2015-2019, respectively. In Myanmar, STC prevalence increased significantly and substantially in 2010-2014, to levels higher than in Bangladesh and India. CONCLUSIONS The prevalence of STC in Bangladesh, India and Myanmar is highest in rural areas and among men. Public health prevention strategies are needed to maintain decrease in STC in Bangladesh and India, and to reverse the increased use in Myanmar.
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Affiliation(s)
- Eva Naznin
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Olivia Wynne
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
| | - Johnson George
- Centre for Medicine Use and Safety, Monash University, Parkville, Vic, Australia
| | - Mohammad Enamul Hoque
- Agency for Clinical Innovation, New South Wales Ministry of Health, Chatswood, NSW, Australia
| | | | - Billie Bonevski
- School of Medicine and Public Health, The University of Newcastle, Callaghan, NSW, Australia
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Hoque ME, Dasgupta SK, Naznin E, Al Mamun A. Household coping strategies for delivery and related healthcare cost: findings from rural Bangladesh. Trop Med Int Health 2015; 20:1368-75. [PMID: 25982905 DOI: 10.1111/tmi.12546] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aims to measure the economic costs of maternal complication and to understand household coping strategies for financing maternal healthcare cost. METHODS A household survey of the 706 women with maternal complication, of whom 483 had normal delivery, was conducted to collect data at 6 weeks and 6 months post-partum. Data were collected on socio-economic information of the household, expenditure during delivery and post-partum, coping strategies adopted by households and other related information. RESULTS Despite the high cost of health care associated with maternal complications, the majority of families were capable of protecting consumption on non-health items. Around one-third of households spent more than 20% of their annual household expenditure on maternal health care. Almost 50% were able to avoid catastrophic spending because of the coping strategies that they relied on. In general, households appeared resilient to short-term economic consequences of maternal health shocks, due to the availability of informal credit, donations from relatives and selling assets. While richer households fund a greater portion of the cost of maternal health care from income and savings, the poorer households with severe maternal complication resorted to borrowing from local moneylenders at high interest, which may leave them vulnerable to financial difficulties. CONCLUSION Financial protection, especially for the poor, may benefit households against economic consequences of maternal complication.
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Affiliation(s)
- Mohammad Enamul Hoque
- School of Public Health, University of Queensland, Brisbane, Qld, Australia.,International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Sushil Kanta Dasgupta
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Eva Naznin
- Campaign for Tobacco Free Kids, Dhaka, Bangladesh
| | - Abdullah Al Mamun
- School of Public Health, University of Queensland, Brisbane, Qld, Australia
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Naznin E, Kroeger A, Siddiqui NA, Sundar S, Malaviya P, Mondal D, Huda MM, Das P, Karki P, Banjara MR, Dreesch N, Gedik G. Human resource assessment for scaling up VL active case detection in Bangladesh, India and Nepal. Trop Med Int Health 2013; 18:734-42. [DOI: 10.1111/tmi.12124] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- E. Naznin
- Special Programme for Research and Training in Tropical Diseases; World Health Organization; Geneva; Switzerland
| | | | - N. A. Siddiqui
- Rajendra Memorial Research Institute of Medical Sciences; Patna; India
| | - S. Sundar
- Banaras Hindu University; Varanasi; India
| | | | - D. Mondal
- International Centre for Diarrhoeal Disease Research Bangladesh (ICDDRB); Dhaka; Bangladesh
| | - M. M. Huda
- International Centre for Diarrhoeal Disease Research Bangladesh (ICDDRB); Dhaka; Bangladesh
| | - P. Das
- Rajendra Memorial Research Institute of Medical Sciences; Patna; India
| | - P. Karki
- University of Heidelberg; Heidelberg; Germany
| | - M. R. Banjara
- Institute of Medicine; Tribhuvan University; Kathmandu; Nepal
| | - N. Dreesch
- Department of Human Resources for Health; World Health Organization; Geneva; Switzerland
| | - G. Gedik
- Department of Human Resources for Health; World Health Organization; Geneva; Switzerland
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Huda MM, Hirve S, Siddiqui NA, Malaviya P, Banjara MR, Das P, Kansal S, Gurung CK, Naznin E, Rijal S, Arana B, Kroeger A, Mondal D. Active case detection in national visceral leishmaniasis elimination programs in Bangladesh, India, and Nepal: feasibility, performance and costs. BMC Public Health 2012; 12:1001. [PMID: 23164318 PMCID: PMC3533526 DOI: 10.1186/1471-2458-12-1001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 11/13/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Active case detection (ACD) significantly contributes to early detection and treatment of visceral leishmaniasis (VL) and post kala-azar dermal leishmaniasis (PKDL) cases and is cost effective. This paper evaluates the performance and feasibility of adapting ACD strategies into national programs for VL elimination in Bangladesh, India and Nepal. METHODS The camp search and index case search strategies were piloted in 2010-11 by national programs in high and moderate endemic districts / sub-districts respectively. Researchers independently assessed the performance and feasibility of these strategies through direct observation of activities and review of records. Program costs were estimated using an ingredients costing method. RESULTS Altogether 48 camps (Bangladesh-27, India-19, Nepal-2) and 81 index case searches (India-36, Nepal-45) were conducted by the health services across 50 health center areas (Bangladesh-4 Upazillas, India-9 PHCs, Nepal-37 VDCs). The mean number of new case detected per camp was 1.3 and it varied from 0.32 in India to 2.0 in Bangladesh. The cost (excluding training costs) of detecting one new VL case per camp varied from USD 22 in Bangladesh, USD 199 in Nepal to USD 320 in India. The camp search strategy detected a substantive number of new PKDL cases. The major challenges faced by the programs were inadequate preparation, time and resources spent on promoting camp awareness through IEC activities in the community. Incorrectly diagnosed splenic enlargement at camps probably due to poor clinical examination skills resulted in a high proportion of patients being subjected to rK39 testing. CONCLUSION National programs can adapt ACD strategies for detection of new VL/PKDL cases. However adequate time and resources are required for training, planning and strengthening referral services to overcome challenges faced by the programs in conducting ACD.
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Affiliation(s)
- M Mamun Huda
- Centre for Communicable Diseases, icddr,b, Dhaka, Bangladesh.
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