The Persistent Association Between Exposure to Intimate Partner Physical Violence and Current Cigarette Smoking Among Women in Papua New Guinea: A Modified Poisson Regression Analysis

Abstract

Background: Intimate partner physical violence (IPPV) is a preventable public health threat associated with health deteriorating lifestyles such as cigarette smoking. However, limited research has focused on the association between IPPV and cigarette smoking among women in unions in low-and middle-income countries like Papua New Guinea (PNG). The aim of this study was to examine the association between IPPV and current cigarette smoking using a nationally representative sample. Methods: We utilized 2016-2018 PNG Demographic and Health Survey data of 9,943 women aged 15-49 years who were in intimate unions. We estimated the direct risk of smoking cigarette using modified Poisson regression models with a robust variance relative risk and 95% confidence intervals (CI) of cigarette smoking. Results: Among the total participants, the prevalence of IPPV was 52.4% and smoking cigarette in the last 24 hours was 25.1%. The modified Poisson regression results indicated a robust and persistent association between IPPV and cigarette smoking among women in unions both in the absence and presence of covariates. The risk of smoking cigarette was significantly elevated among those who reported a history of IPPV relative to their counterparts with no physical violence history (IRR: 1.35, 95%CI: 1.20-1.52) in the absence of covariates. After controlling for demographic, social and economic variables, the association between IPPV and cigarette smoking persisted (IRR: 1.24, 95%CI: 1.08-1.41). Conclusions: The present study provides strong evidence to indicate a robust and persistent association between IPPV and current cigarette smoking among women in unions. Interventions aimed at addressing IPPV among women in unions in PNG to reduce the increased risk of cigarette smoking are needed.