Prevalence and Correlates of Smokeless Tobacco Consumption among Married Women in Rural Bangladesh

Abstract

ObjectiveTo estimate the prevalence and identify correlates of smokeless tobacco consumption among married rural women with a history of at least one pregnancy in Madaripur, Bangladesh.Materials and MethodsWe conducted a cross-sectional survey using an interviewer administered, pre-tested, semi-structured questionnaire. All women living in the study area, aged 18 years and above with at least one pregnancy in their lifetime, who were on the electoral roll and agreed to participate were included in the study. Information on socio-demographic characteristics and smokeless tobacco consumption was collected. Smokeless tobacco consumption was categorized as ‘Current’, ‘Ever but not current’ and ‘Never’. Associations between smokeless tobacco consumption and the explanatory variables were estimated using simple and multiple binary logistic regression.Results8074 women participated (response rate 99.9%). The prevalence of ‘Current consumption’, ‘Ever consumption but not current’, and ‘Never consumption’ was 25%, 44% and 31%, respectively. The mean age at first use was 31.5 years. 87% of current consumers reported using either Shadapata or Hakimpuree Jarda. Current consumption was associated with age, level of education, religion, occupation, being an income earner, marital status, and age at first use of smokeless tobacco. After adjustment for demographic variables, current consumption was associated with being over 25 years of age, a lower level of education, being an income earner, being Muslim, and being divorced, separated or widowed.ConclusionThe prevalence of smokeless tobacco consumption is high among rural women in Bangladesh and the age of onset is considerably older than that for smoking. Smokeless tobacco consumption is likely to be producing a considerable burden of non-communicable disease in Bangladesh. Smokeless tobacco control strategies should be implemented.

Current Pattern of Product Specific Smokeless Tobacco Use in Bangladesh

“…Smokeless tobacco product consumption is socially well accepted in Bangladesh and it is a tradition of culture that older people gossips together to pass their time and offers tobacco with zarda to chew. The same scenario was found in previous studies [14].…”

Health knowledge and smokeless tobacco quit attempts and intentions among married women in ruralBangladesh: Cross‐sectional survey

“…We selected two local government areas: Jhaudi and Ghotmajhee of Madaripur district which are located 220 km south of Dhaka, the capital city. The demographic characteristics of the study area were similar to those in other rural areas of Bangladesh, with respect to sex ratio, per capita income, household size, literacy rate, life expectancy, occupation and marital status, although the proportion of Hindus was lower than the national average [13,25]. The population of interest was married women aged ≥18 years with at least one pregnancy in their lifetime.…”

“…The most commonly consumed forms of smokeless tobacco by rural women in Bangladesh are locally grown products Shadapata and Hakimpuree Zarda presumably due to their low price and availability [13]. STC is popular among lower socioeconomic groups in Bangladesh such as poor, semi‐skilled manual workers, unemployed people and those with little or no formal education [14].…”

Pulmonary Effects of Maternal Smoking on the Fetus and Child: Effects on Lung Development, Respiratory Morbidities, and Life Long Lung Health

“…Rates of smoking during pregnancy in Canada are roughly similar to that of the US (11). While use of combustible tobacco products during pregnancy is generally more common than smokeless products, in India and Bangladesh use of smokeless tobacco during pregnancy is approaching 25% (12) partially reflecting a perception of health benefits for smokeless tobacco products as well as their low cost. The use of smokeless tobacco products during pregnancy is also common in Sweden and among Alaskan Native Americans in the US.…”