Use of Smoke-less Tobacco Amongst the Staff of Tertiary Care Hospitals in the Largest City of Pakistan

Abstract

Background: Use of smoke-less tobacco (SLT) is very common in South and South-East Asian countries. It is significantly associated with various types of cancers. The objectives of this study were to assess the proportion of hospital staff that use SLT, and to identify the factors associated with its use and their practices. Methods: In a cross-sectional study, 560 staff of two tertiary care hospitals were interviewed in the year 2009. Nurses, ward boys and technicians were counted as a paramedic staff while drivers, peons, security guards and housekeeping staff were labeled as non-paramedic staff. SLT use was considered as usage of any of the following: betel quid (paan) with or without tobacco, betel nuts with or without tobacco (gutkha) and snuff (naswar). Results: About half (48.6%) of the hospital staff were using at least one type of SLT. Factors found to be statistically significant with SLT were being a male (OR=2.5; 95% CI=1.8-3.7); having no/fewer years of education (OR=1.7; 95% CI=1.2-2.4) and working as non-paramedic staff (OR=2.6; 95% CI=1.8-3.8). Majority of SLT users were using it on regular basis, for > 5 years and keeping the tobacco products in the oral cavity for >30 minutes. About half of the users started due to peer pressure and had tried to quit this habit but failed. Conclusion: In this study, about half of the study participants were using SLT in different forms. We suggest educational and behavioral interventions for control of SLT usage.

Smokeless Tobacco (Shammah) in Saudi Arabia: A Review of its Pattern of Use, Prevalence, and Potential Role in Oral Cancer

“…Use of smoke-less tobacco (SLT) is very common in South and South-East Asian countries (Valliani et al, 2012). Shammah is used in KSA and Yemen.…”

“…The study showed that a high percentage of paramedical staff of public sector hospitals consume ST in different forms. Most common type consumed is 'Gutka' and their family or friends influenced approximately half of them (Valliani et al, 2012). A relatively high prevalence of smokeless tobacco consumption among the male students of universities of Zahedan, Iran (Honarmand et al, 2013).…”

Factors Associated with Helicobacter Pylori Infection, Results from a Developing Country-Pakistan

“…The increasing risk factor includes; poor sanitary conditions, overpopulation, consumption of raw foods, like food items purchased from street stalls and unsafe water supply sources (Zhong et al, 2012). Smoking and smokeless tobacco use are associated with increasing risk of H. pylori, which is very common in south Asian countries, mainly Pakistan (Wu et al, 2003;Valliani et al, 2012). Some studies reported that alcohol is protected against infection while coffee had the opposite effect, but these results are variable (Wu et al, 2003).…”

Eco-Epidemiology and Control of Waterborne Gastroenteritis: A Review

“…By avoiding this habit, risk of this illness can be minimized [4]. For control and prevention of pathogenic bacteria from spreading, food and water should be treated in such a way that there would be no or minimum chances of contamination [60].…”

“…From 2008 to 2015, one million deaths have been recorded in Pakistan alone which reflects the severity and primarily significance of this notorious infection [2]. Outbreaks of gastroenteritis primarily depends upon a variety of risk factors among children and adults such as contaminated pond water which was used for washing, bathing, drinking and cooking purposes without boiling [3], use of smokeless tobacco [4], malnutrition, excessive use of antibiotics as well as psychological factors such as anxiety, depression [5] and immunocompromised patients [6].…”