Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health Surveys

Abstract

BackgroundIn South and Southeast Asian countries, tobacco is consumed in diverse forms, and smoking among women is very low. We aimed to provide national estimates of prevalence and social determinants of smoking and smokeless tobacco use among men and women separately.MethodsData from Demographic and Health Surveys completed in nine countries (India, Pakistan, Nepal, Bangladesh, Maldives, Philippines, Cambodia, Indonesia, and Timor Leste) were analyzed. Current smoking or smokeless tobacco use was assessed as response “yes” to one or more of three questions, such as “Do you currently smoke cigarettes?” Weighted country-level prevalence rates for socio-economic subgroups were calculated for smoking and smokeless tobacco use. Binary logistic regression analyses were done on STATA/IC (version 10) by ‘svy’ command.ResultsPrevalence and type of tobacco use among men and women varied across the countries and among socio-economic sub groups. Smoking prevalence was much lower in women than men in all countries. Smoking among men was very high in Indonesia, Maldives, and Bangladesh. Smokeless tobacco (mainly chewable) was used in diverse forms, particularly in India, among both men and women. Chewing tobacco was common in Nepal, Bangladesh, Maldives, and Cambodia. Both smoking and smokeless tobacco use were associated with higher age, lower education, and poverty, but their association with place of residence and marital status was not uniform between men and women across the countries.ConclusionPolicymakers should consider type of tobacco consumption and their differentials among various population subgroups to implement country-specific tobacco control policies and target the vulnerable groups. Smokeless tobacco use should also be prioritized in tobacco control efforts.

Educational and wealth inequalities in tobacco use among men and women in 54 low-income and middle-income countries

“…In addition to smoking manufactured and hand-rolled cigarettes and loose tobacco in pipes, smokeless tobacco consumption, such as chewing ( khaini, surti, paan masala ) and inhalation (snuff, and snus), is common in South and Southeast Asian countries,6 7 whereas water pipe smoking is common in the Middle East and Russia 8. Smokeless tobacco use also contributes to the global disease burden, causing 6 million DALYs lost and a quarter million deaths due to cancers of mouth, pharynx and oesophagus9 and ischaemic heart disease, mostly among men and mainly in Southeast Asia 10…”

Time-to-Pregnancy Associated With Couples’ Use of Tobacco Products

“…3 In other parts of the world, smokeless tobacco use is relatively more common and may be more common than smoking, particularly among women. 4,5 Given the morbidity and mortality associated with cigarette smoking, particularly lung cancer and respiratory diseases, some researchers have touted smokeless tobacco as a harm reduction tool for smokers who cannot cease nicotine use completely. 6 If smokers, particularly those of reproductive age hopeful for future children, are to be properly counseled about the risks and benefits of smokeless tobacco for harm reduction, then the reproductive toxicity of smokeless tobacco needs to be disclosed.…”

Prevalence of Tobacco Smoking and Factors Associated with the Initiation of Smoking among University Students in Dhaka, Bangladesh

“…22 A study based on demographic and health survey data reported that the prevalence of tobacco smoking among men in Bangladesh is 60%. 23 Another study among male university students in 2009 stated that 36.1% students smoked tobacco. 24 Among fourthyear dental students, the prevalence of cigarette smoking was reported to be 49.5% and 1.7% in males and females, respectively.…”