Background Tobacco smoking and use of smokeless tobacco are the most preventable cause of death in Bangladesh. The prevalence of psychological distress is increasing globally. This paper reports the smoking status and their association with psychological distress and other factors in a rural district, Narail, of Bangladesh. Materials and Methods Data were collected from 2425 adults of age 18–90 years. Smoking status along with sociodemographic characteristics and measures of psychological distress using the Kessler 10-item questionnaire were collected using a face-to-face data collection method. Results The crude (age-standardized) prevalence of ever smoking was 27.1 (24.3)% that includes current 25.6 (23.7) and smoker 1.5 (0.6)%, and the prevalence of smokeless tobacco (SLT) was 23.5 (13.4)%. The prevalence of ever smoking was the highest in daily labourers (62.9%) and SLT use was the highest in widowed people (47.2%). After adjustment for covariates, no education (odds ratio (OR): 3.78, 95% confidence interval (CI): 1.57–9.07 for females and OR: 2.69, 95% CI: 1.87–3.87 for males) compared to at least secondary level of education and daily labours (OR: 6.66, 95% CI: 1.67–26.6 for females and OR: 5.12, 95% CI: 1.30–20.19 for males) compared to housework were associated with higher prevalence of ever smoking. Any level of psychological distress, such as mild psychological distress, was associated with at least double the prevalence of tobacco smoking in females (OR: 2.12, 95% CI: 1.67–3.83) but not in males (OR: 1.12, 95% CI: 0.80–1.56). Psychological distress was not associated with SLT use. Conclusions Prevalence of both smoking and SLT use was high, particularly in daily labourers, people with no education, and females with psychological distress in rural Bangladesh. Appropriate intervention programs should especially target those of low levels of education and laborious occupations for increasing awareness for the cessation of smoking in rural Bangladesh.
INTRODUCTION:
The American College of Obstetrics and Gynecology states asking pregnant patients about family history (FHx) of genetic disease plays an important role in identifying and managing pregnancies with higher risk of genetic conditions. Few studies have assessed these conversations between pregnant patients and their obstetric care providers (OBS).
METHODS:
IRB approval was obtained to collect audio recordings and to transcribe conversations between pregnant patients and OBS during the first obstetric visit. A formulated codebook identified conversation segments containing FHx and genetic disorders and labeled the content of conversations. An independent coder reviewed transcripts to insure intercoder reliability, validity and accuracy. We identified communication patterns, categories, and themes.
RESULTS:
Of 152 transcripts, FHx was discussed in 93% of conversations. Genetic disorders most commonly mentioned were Down Syndrome (89%), Cystic Fibrosis (78%) and Sickle Cell Disease (75%). These were often discussed in the context of genetic screening tests. OBS asked patients to identify their ethnicity in 40% of visits. The father of the baby was present for 32% of visits, father’s ethnicity assessed in 51%, and father’s FHx discussed 48% of the time. Father’s presence at the visit was not associated with likelihood of OBS asking about their FHx. In 10% of visits OBS conveyed assumptions that if the patient did not recognize a disease, this represented a negative FHx for that disorder.
CONCLUSION:
While OBS assessed FHx in most first obstetric visits, communication approaches used in these assessments may not elicit complete information given that specific disorders and father’s FHx were not consistently discussed.
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