Nair Saritha, Schensul Jean J, Begum Shahina, Pednekar Mangesh S, Oncken Cheryl, Bilgi Sameena M, Pasi Achhelal R, Donta Balaiah
National Institute of Medical Statistics, New Delhi, India.
Institute for Community Research, Hartford, Connecticut, United States of America.
PLoS One. 2015 Mar 18;10(3):e0119814. doi: 10.1371/journal.pone.0119814. eCollection 2015.
This paper discusses patterns of daily smokeless tobacco (SLT) use and correlates of poly SLT use among married women aged 18-40 years in a Mumbai slum community with implications for tobacco control.
Using a mixed methods approach, the study included a structured survey with 409 daily SLT users and in-depth interviews with 42 women. Participants for the survey were selected using a systematic sampling procedure (one woman in every fourth eligible household). Univariate and bivariate analysis, and multiple logistic regressions were conducted to identify demographic and social factors associated with women's use of poly SLT products. To illustrate survey results, in-depth interviews were analyzed using Atlas ti software.
Sixty-four percent of the women surveyed used only one type of SLT; of these, 30% used mishri, 32% used pan with tobacco and the rest used chewed tobacco (11%), gul (17%) or gutkha (10%). Thirty-six percent used more than one type of SLT. Poly SLT users chewed or rubbed 50% more tobacco as compared to single users (mean consumption of tobacco per day: 9.54 vs. 6.49 grams; p<0.001). Women were more likely to be poly SLT users if they were illiterate as compared to literate (adjusted odds ratio [AOR]=1.67; 95% confidence interval [CI]=1.07-2.71), if they had lived in Mumbai for 10 years or more, versus less than ten years (AOR=1.67, 95% CI=1.03-2.71); and if their husband was a poly SLT user as compared to a non SLT user (AOR=2.78, 95% CI=1.63-4.76). No differences were noted between pregnant and non-pregnant women in SLT consumption patterns.
Tobacco control policies and programs must focus specifically on both social context and use patterns to address SLT use among women of reproductive age with special attention to poly SLT users, an understudied and vulnerable population.
本文探讨了孟买贫民窟社区18至40岁已婚女性每日无烟烟草（SLT）的使用模式以及多种SLT使用的相关因素，对烟草控制具有启示意义。
采用混合方法，该研究包括对409名每日SLT使用者进行的结构化调查以及对42名女性进行的深入访谈。调查参与者采用系统抽样程序选取（每四户符合条件的家庭中选一名女性）。进行单变量和双变量分析以及多重逻辑回归，以确定与女性使用多种SLT产品相关的人口统计学和社会因素。为说明调查结果，使用Atlas ti软件对深入访谈进行分析。
64%的受访女性仅使用一种类型的SLT；其中，30%使用蜜饯，32%使用带烟草的槟榔，其余使用嚼烟（11%）、古勒（17%）或古特卡（10%）。36%的女性使用不止一种类型的SLT。与单一使用者相比，多种SLT使用者咀嚼或摩擦的烟草多50%（每日烟草平均消费量：9.54克对6.49克；p<0.001）。与识字女性相比，文盲女性更有可能是多种SLT使用者（调整后的优势比[AOR]=1.67；95%置信区间[CI]=1.07 - 2.71）；与在孟买居住不到十年的女性相比，在孟买居住10年或更长时间的女性更有可能是多种SLT使用者（AOR=1.67，95% CI=1.03 - 2.71）；与非SLT使用者的丈夫相比，丈夫是多种SLT使用者的女性更有可能是多种SLT使用者（AOR=2.78，95% CI=1.63 - 4.76）。在SLT消费模式方面，未发现孕妇和非孕妇之间存在差异。
烟草控制政策和计划必须特别关注社会背景和使用模式，以解决育龄女性中的SLT使用问题，尤其要关注多种SLT使用者这一研究不足且易受影响的人群。
