Use of Smokeless Tobacco by Indian Women Aged 18–40 Years during Pregnancy and Reproductive Years

Abstract

ObjectivesThis paper discusses patterns of daily smokeless tobacco (SLT) use and correlates of poly SLT use among married women aged 18–40 years in a Mumbai slum community with implications for tobacco control.MethodsUsing a mixed methods approach, the study included a structured survey with 409 daily SLT users and in-depth interviews with 42 women. Participants for the survey were selected using a systematic sampling procedure (one woman in every fourth eligible household). Univariate and bivariate analysis, and multiple logistic regressions were conducted to identify demographic and social factors associated with women’s use of poly SLT products. To illustrate survey results, in-depth interviews were analyzed using Atlas ti software.ResultsSixty-four percent of the women surveyed used only one type of SLT; of these, 30% used mishri, 32% used pan with tobacco and the rest used chewed tobacco (11%), gul (17%) or gutkha (10%). Thirty-six percent used more than one type of SLT. Poly SLT users chewed or rubbed 50% more tobacco as compared to single users (mean consumption of tobacco per day: 9.54 vs. 6.49 grams; p<0.001). Women were more likely to be poly SLT users if they were illiterate as compared to literate (adjusted odds ratio [AOR]=1.67; 95% confidence interval [CI]=1.07-2.71), if they had lived in Mumbai for 10 years or more, versus less than ten years (AOR=1.67, 95% CI=1.03-2.71); and if their husband was a poly SLT user as compared to a non SLT user (AOR=2.78, 95% CI=1.63-4.76). No differences were noted between pregnant and non-pregnant women in SLT consumption patterns.ConclusionsTobacco control policies and programs must focus specifically on both social context and use patterns to address SLT use among women of reproductive age with special attention to poly SLT users, an understudied and vulnerable population.

White paper on smokeless tobacco & women's health in India

“…SLT use is found to be positively associated with its use by partner or peers 23 24 . In a study conducted among married women at Mumbai, India, SLT use was found to be attributed for reducing stress, providing pleasure, associated companionship with peers at workplace and in the neighbourhood, increasing energy for workload and suppressing hunger when dietary requirements were not met 25 . Further, SLT use is often initiated at an early age as children and youth are often exposed to it when involved in purchase activities for their mothers and other older family members 26 .…”

Possible role of nicotine and cotinine on nitroxidative stress and antioxidant content in saliva of smokeless tobacco consumers

“…Oral smokeless tobacco products are placed in the mouth, cheek or lip and sucked (dipped) or chewed [1] . India is one of the largest producers and consumers of tobacco, most of it in the smokeless tobacco form and available in different brands across the country [2] . It is estimated that 5500 adolescents consume tobacco every day in India and every year 4 million young people are starting the consumption of tobacco regularly [3] .…”

Prevalence, pattern and sociodemographic differentials in smokeless tobacco consumption in Bangladesh: evidence from a population-based cross-sectional study in Chakaria

“…Use of SLT is also believed to be helpful during the early period of pregnancy by reducing vomiting and increasing the appetite. 41 …”