Hussain Azmina, Zaheer Sidra, Shafique Kashif
Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, OJHA Campus, Suparco Road, Gulzar-e-Hijri, Scheme, Karachi, 33, Pakistan.
School of Public Health, Dow University of Health Sciences, OJHA Campus, SUPARCO road, Gulzar e Hijri, Karachi, Pakistan.
BMC Public Health. 2017 Nov 28;17(1):913. doi: 10.1186/s12889-017-4916-1.
With 600 million people using betel quid (BQ) globally, and smokeless tobacco (SLT) use being more wide-spread; the duo is an uphill public health concern in South Asian countries. SLT and/or BQ use increases the risk for morbidity and mortality from oral cancer. Because SLT and/or BQ use is initiated during adolescence, it renders this group more vulnerable; and particular attention is needed to curb SLT and/or BQ use to reduce related disease burden. We aimed to observe the differential individual, social and environmental features amongst SLT and/or BQ users to determine the key influencers of its use in adolescents.
This study was a cross-sectional survey of 2140 adolescents from secondary schools of Karachi, Pakistan. The main outcome measure was SLT and/or BQ use based on their consumption in the past 30 days. Univariate and multivariate regression binary logistic analyses were employed while reporting results in both crude form and adjusted odds ratio (after adjusting for all remaining individual, social and environmental level variables) with 95% confidence level. A p-value of < .05 was considered significant for all analyses.
The overall prevalence of SLT and/or BQ use was 42.6% (n = 912) of the total sample. The SLT and/or BQ consumer group had more males than females. A significant proportion of user (n = 558, 61.2%) was found in co-education schools. Students whose peers (OR = 6.79, 95% CI 4.67-9.87, p-value <0.001) and/or either of the parents (OR = 2.16, 95% CI 1.73-2.65, p-value <0.001) used SLT and/or BQ, alongside, adolescents who had not attended knowledge based sessions in schools regarding harmful effects of SLT and/or BQ were more likely to consume it. It's availability with outside school hawkers increased the odds of its use by 6 times, as indicated by both univariate and multivariate models after adjusting for the remaining variables.
In conclusion, students studying in co-education, parents and peers use, lack of knowledge based sessions on harmful health effects of SLT and/or BQ, and easy availability of the product from hawkers outside school all contribute towards enhanced risk of SLT and/or BQ use in adolescents.
全球有6亿人使用槟榔（BQ），无烟烟草（SLT）的使用更为广泛；在南亚国家，这两者对公共卫生而言是严峻挑战。使用SLT和/或BQ会增加患口腔癌的发病和死亡风险。由于SLT和/或BQ的使用始于青春期，这使得该群体更易受到影响；因此需要特别关注以遏制SLT和/或BQ的使用，从而减轻相关疾病负担。我们旨在观察SLT和/或BQ使用者之间个体、社会和环境特征的差异，以确定青少年使用SLT和/或BQ的关键影响因素。
本研究是对巴基斯坦卡拉奇市中学的2140名青少年进行的横断面调查。主要观察指标是根据过去30天内的消费情况来确定SLT和/或BQ的使用情况。采用单因素和多因素回归二元逻辑分析，并以原始形式和调整后的优势比（在对所有其余个体、社会和环境层面变量进行调整后）报告结果，置信水平为95%。所有分析中，p值<0.05被认为具有统计学意义。
在总样本中，SLT和/或BQ的总体使用率为42.6%（n = 912）。SLT和/或BQ消费群体中男性多于女性。在男女同校的学校中发现了相当比例的使用者（n = 558，61.2%）。其同龄人（优势比=6.79，95%置信区间4.67 - 9.87，p值<0.001）和/或父母一方（优势比=2.16，95%置信区间1.73 - 2.65，p值<0.001）使用SLT和/或BQ的学生，以及未参加过关于SLT和/或BQ有害影响的学校知识讲座的青少年，更有可能使用它。在校外小贩处容易买到SLT和/或BQ会使其使用几率增加6倍，单因素和多因素模型在对其余变量进行调整后均表明了这一点。
总之，在男女同校就读的学生、父母和同龄人使用、缺乏关于SLT和/或BQ对健康有害影响的知识讲座，以及在校外小贩处容易买到该产品，所有这些因素都导致青少年使用SLT和/或BQ的风险增加。
