Department of Clinical Sciences, Faculty of Medical and Health Science, University Tunku Abdul Rahman, Bandar Sungai Long, Kajang, Selangor, Malaysia.
Subst Abuse Treat Prev Policy. 2011 Dec 20;6:33. doi: 10.1186/1747-597X-6-33.
Nearly four-fifths of estimated 1.1 million smokers live in low or middle-income countries. We aimed to provide national estimates for Nepal on tobacco use prevalence, its distribution across demographic, socio-economic and spatial variables and correlates of tobacco use.
A secondary data analysis of 2006 Nepal Demographic and Health Survey (DHS) was done. A representative sample of 9,036 households was selected by two-stage stratified, probability proportional to size (PPS) technique. We constructed three outcome variables 'tobacco smoke', 'tobacco chewer' and 'any tobacco use' based on four questions about tobacco use that were asked in DHS questionnaires. Socio-economic, demographic and spatial predictor variables were used. We computed overall prevalence for 'tobacco smoking', 'tobacco chewing' and 'any tobacco use' i.e. point estimates of prevalence rates, 95% confidence intervals (CIs) after adjustment for strata and clustering at primary sampling unit (PSU) level. For correlates of tobacco use, we used multivariate analysis to calculate adjusted odds ratios (AORs) and their 95% CIs. A p-value < 0.05 was considered as significant.
Total number of households, eligible women and men interviewed was 8707, 10793 and 4397 respectively. The overall prevalence for 'any tobacco use', 'tobacco smoking' and 'tobacco chewing' were 30.3% (95% CI 28.9, 31.7), 20.7% (95% CI 19.5, 22.0) and 14.6% (95% CI 13.5, 15.7) respectively. Prevalence among men was significantly higher than women for 'any tobacco use' (56.5% versus 19.6%), 'tobacco smoking' (32.8% versus 15.8%) and 'tobacco chewing' (38.0% versus 5.0%). By multivariate analysis, older adults, men, lesser educated and those with lower wealth quintiles were more likely to be using all forms of tobacco. Divorced, separated, and widowed were more likely to smoke (OR 1.49, 95% CI 1.14, 1.94) and chew tobacco (OR 1.36, 95% CI 0.97, 1.93) as compared to those who were currently married. Prevalence of 'tobacco chewing' was higher in eastern region (19.7%) and terai/plains (16.2%). 'Tobacco smoking' and 'any tobacco use' were higher in rural areas, mid-western and far western and mountainous areas.
Prevalence of tobacco use is considerably high among Nepalese people. Demographic and socioeconomic determinants and spatial distribution should be considered while planning tobacco control interventions.
据估计，110 万烟民中近五分之四生活在中低收入国家。我们旨在为尼泊尔提供烟草使用流行率的国家估计数，以及这些流行率在人口统计学、社会经济和空间变量中的分布情况，以及与烟草使用相关的因素。
对 2006 年尼泊尔人口与健康调查（DHS）进行了二次数据分析。采用两阶段分层、概率与规模成比例（PPS）技术对 9036 户家庭进行了代表性抽样。我们根据 DHS 问卷中询问的四个关于烟草使用的问题，构建了三个结果变量“烟草烟雾”、“烟草咀嚼”和“任何形式的烟草使用”。使用了社会经济、人口统计学和空间预测变量。我们计算了“吸烟”、“咀嚼烟草”和“任何形式的烟草使用”的总体流行率，即调整了层和初级抽样单位（PSU）水平的聚类后，流行率的点估计值和 95%置信区间（CI）。对于烟草使用的相关因素，我们使用多变量分析计算了调整后的优势比（AOR）及其 95%CI。p 值<0.05 被认为具有统计学意义。
合格的家庭总数、接受访谈的妇女和男子分别为 8707、10793 和 4397。“任何形式的烟草使用”、“吸烟”和“咀嚼烟草”的总体流行率分别为 30.3%（95%CI 28.9，31.7）、20.7%（95%CI 19.5，22.0）和 14.6%（95%CI 13.5，15.7）。男性的“任何形式的烟草使用”、“吸烟”和“咀嚼烟草”的流行率明显高于女性，分别为 56.5%比 19.6%、32.8%比 15.8%和 38.0%比 5.0%。多变量分析显示，年龄较大、男性、教育程度较低和财富五分位数较低的人更有可能使用所有形式的烟草。与目前已婚者相比，离婚、分居和丧偶者更有可能吸烟（OR 1.49，95%CI 1.14，1.94）和咀嚼烟草（OR 1.36，95%CI 0.97，1.93）。“咀嚼烟草”的流行率在东部地区（19.7%）和特赖/平原地区（16.2%）较高。“吸烟”和“任何形式的烟草使用”在农村地区、中西部和远西部以及山区更为普遍。
尼泊尔人民的烟草使用流行率相当高。在规划烟草控制干预措施时，应考虑人口统计学和社会经济决定因素以及空间分布情况。
