Systematic review and meta‐analysis of the prevalence of smokeless tobacco consumption among adults in Bangladesh, India and Myanmar

Naznin, Eva; Wynne, Olivia; George, Johnson; Hoque, Mohammad Enamul; Milton, Abul Hasnat; Bonevski, Billie

doi:10.1111/tmi.13410

Cited by 6 publications

(5 citation statements)

References 33 publications

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“…According to the study, the pooled prevalence of SLT usage was 25% and 22%, respectively. [38] In this review, there is a wide disparity between our overall CTU estimate (35.25%) and individual SLT or smoke form usage estimate. Though our SLT/ smoke form usage estimate aligns well with recent nationalized survey reports, we acknowledge that the inadequacy of tobacco type-specific usage data among included studies may have underestimated our tobacco type-specific estimates.…”

Section: Discussionmentioning

confidence: 88%

Tobacco usage among general Indian population: A meta-analysis of evidence drawn from regional studies between 2010 - 2022

Pahari¹,

Barman²,

Talukdar³

2023

Preprint

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Objectives The purpose of this review is to generate a national and zonal pooled estimate of Current Tobacco Usage (CTU) in any form, as well as stratified gender and tobacco type (smokeless & smoke) specific estimates among the general Indian population, utilizing evidence from 2010 to 2022. Method PubMed, Scopus, Science Direct, CINAHL and Google Scholar databases were searched for articles on tobacco use among Indian adults published between January 2010 and October 2022. The NIH Quality Assessment Tool was used to assess study quality, and a random-effects inverse-variance method was used to attain a pooled estimate of usage. Heterogeneity was estimated through I2 statistics and prediction intervals, and further subgroup analysis and meta regression were conducted. To estimate publication bias egger test was performed and a leave one out analysis was done to establish the sensitivity of our overall pooled estimate. Results CTU of any form amongst the Indian population irrespective of age group was 35.25% (Confidence Interval (CI) 25.27 to 45.92, I2 99.7, P value < 0.001) between the years 2010 to 2022, whereas through 2016 to 2022 regionally drawn estimate was 44.38% (CI 30.57 to 58.64, I2 99.8, P value < 0.01). The region wise highest prevalence was found in the East zone (55.43%) followed by North East with 51.88% consumption. Though residual heterogeneity was present after subgroup analysis, Variability in estimates was statistically significant by administrative zones and gender-wise consumption (test of subgroup difference P value <0.0001). Leave one out analysis proved consistency in our overall CTU estimate. Conclusion The differences between national-level surveys and regional estimates are highlighted in this review and thereby warrant more regionally representative surveys of tobacco usage for tailor-making prevention efforts alongside, increased regional efforts, improved community level advocacy, and more coordinated and stringent tobacco prevention policy implementation at national and state levels.

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Section: Discussionmentioning

confidence: 88%

Tobacco usage among general Indian population: A meta-analysis of evidence drawn from regional studies between 2010 - 2022

Pahari¹,

Barman²,

Talukdar³

2023

Preprint

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“…They utilised regional studies as well as studies and reports based on secondary data, and nationalised surveys. According to the study, the pooled prevalence of SLT usage was 25% and 22%, respectively [51].…”

Section: Discussionmentioning

confidence: 99%

Tobacco usage in India: A meta‐analysis of evidence drawn from regional studies between 2010 and 2022

Pahari¹,

Barman

Talukdar

2023

Tropical Med Int Health

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ObjectivesTo generate a national and zonal pooled estimate of current tobacco usage (CTU) in any form, as well as stratified gender and tobacco type (smokeless and smoke) specific estimates among the Indian population, utilising evidence from 2010 to 2022.MethodPubMed, Scopus, ScienceDirect, CINAHL and Google Scholar databases were searched for articles on tobacco use among Indian adults published between January 2010 and October 2022. The NIH Quality Assessment Tool was used to assess study quality, and a random‐effects inverse‐variance method was used to attain a pooled estimate of usage. Heterogeneity was estimated through I2 statistics and prediction intervals, and further subgroup analysis and meta‐regression were conducted. A leave‐one‐out analysis was done to establish the sensitivity of the pooled estimate.ResultsCTU prevalence of any form among the adult Indian population was 35.2% [confidence interval (CI) 25.27–45.92, I2 = 99.7, p < 0.001] between 2010 and 2022 with a wide Prediction interval between 3.19 to 78.74. The regionally drawn estimate for the years 2016–2022 was 44.3% (CI 30.57–58.64, I2 = 99.8, p < 0.01). Highest prevalence was found in the East zone (55.4%) followed by the northeast with 51.8% tobacco consumption. Although residual heterogeneity persisted after subgroup analysis, the variability in estimates showed statistical significance when considering disaggregated estimates across administrative zones and gender‐wise consumption. The estimated CTU among males was 54.1%, whereas in females it was 15%. Leave‐one‐out analysis indicated the findings are reliable and are not dependent on any one study.ConclusionThis review highlights differences in tobacco usage estimates from national‐level surveys and regional studies. More regionally representative surveys of tobacco usage to tailormade prevention efforts alongside increased regional efforts improved community‐level advocacy and more coordinated and stringent tobacco prevention policy implementation at national and state levels are warranted.

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“…In India, SLT consumption is a habit more commonly observed in socioeconomically deprived and less literate Indian men [32]. However, in a few states of India, the SLT consumption in women is very high and is comparable to that of the male population [8]. SLT users often deface public places in many Indian cities by spitting, a practice prevalent in tiny congested low socio-economic dwellings and urban slums.…”

Section: Smokeless Tobacco Habitués: Spitting In Public and Covid-19 mentioning

confidence: 99%

“…Many Asian and Western Pacific countries use an array of SLT products such as snus, tobacco tooth powders, snuff, gutkha, khaini, tobacco powder, mawa, jarda, mishri, and tobacco paste [ 5 - 7 ]. Currently, the South Asian region accounts for 90% of the global consumption of SLT, with a majority in Bangladesh (25%), India (22%), and Myanmar (21%) [ 8 ].…”

Section: Reviewmentioning

confidence: 99%

COVID-19 in Smokeless Tobacco Habitués: Increased Susceptibility and Transmission

Gaunkar¹,

Nagarsekar²,

Carvalho³

et al. 2020

Cureus

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As the coronavirus disease (COVID-19) pandemic continues to sweep across the globe, the world is responding by implementing public awareness campaigns, social distancing measures, and other preventive strategies to arrest the spread of this lethal disease. Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exacts a heavy toll on patients with existing comorbidities. Smokeless tobacco (SLT) consumption is of particular concern in countries in South Asia with high population densities, as it facilitates exposure to SARS-CoV-2 within or between communities by the act of public spitting. Salivary droplets generated in this act are a potential threat because they can transmit this airborne infection. Moreover, large gatherings at tobacco retail outlets, frequent hand-to-mouth contact, and sharing of apparatus by SLT habitués could also aid in increasing the spread of SARS-CoV-2. SLT-induced higher expression of angiotensin-converting enzyme 2 receptors along with the presence of furin in the oral mucosa and dysfunctional immune responses among SLT habitués increase viral dissemination and an individual's susceptibility to COVID-19. Issuing rigorous regulations to restrict the use of various forms of SLT products and the obnoxious act of spitting in public can assist in arresting the spread of COVID-19. Widespread education campaigns enlightening the community regarding the adverse effects of SLT consumption and its relationship with COVID-19, along with providing effective assistance to quit for those who are addicted, would decrease the spread of COVID-19.

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Systematic review and meta‐analysis of the prevalence of smokeless tobacco consumption among adults in Bangladesh, India and Myanmar

Cited by 6 publications

References 33 publications

Tobacco usage among general Indian population: A meta-analysis of evidence drawn from regional studies between 2010 - 2022

Tobacco usage among general Indian population: A meta-analysis of evidence drawn from regional studies between 2010 - 2022

Tobacco usage in India: A meta‐analysis of evidence drawn from regional studies between 2010 and 2022

COVID-19 in Smokeless Tobacco Habitués: Increased Susceptibility and Transmission

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