Sharma Deepak, Goel Sonu, Lal Pranay
Department of Community Medicine, Government Medical College and Hospital, Chandigarh, India.
School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Cancer. 2017 Jul-Sep;54(3):584-588. doi: 10.4103/ijc.IJC_345_17.
Tobacco use and education of an individual are linked to each other. Educated people are more likely to practice healthy behaviors and are aware of the harms of tobacco use. This paper uses the Global Adult Tobacco Survey data (GATS-India) to study the education differential associated with tobacco use and its predictors across India.
Secondary data analysis was conducted for GATS conducted in 2009-2010 in India. Data for "illiterate" and "literate" study subjects were analyzed according to study subject's "tobacco consumption pattern," their "quitting behavior," "exposure to second hand smoke (SHS)" and "observing health warnings on tobacco products."
Tobacco smokers and smokeless tobacco users were more likely to be illiterate (odds ratio [OR] for smoking tobacco = 1.2; for smokeless tobacco = 1.5) as compared to their counterparts. Significantly, more illiterate initiated smoking tobacco (OR = 1.1; 1.02-1.26) and smokeless tobacco habit (OR = 1.3; 1.21-1.44) before 17 years of age. Illiterate people were less likely to try quitting tobacco (smoking tobacco = OR = 0.8; 0.79-0.94; smokeless tobacco = OR = 0.7; 0.70-0.81) and also less likely to think of quitting tobacco in near future (smoking tobacco = OR = 0.6; 0.59-0.71; smokeless tobacco = OR = 0.6; 0.57-0.66). Illiterate people were more likely to be exposed to SHS at home (OR = 1.8; 1.7-1.9) and less likely to notice health warnings on cigarette packets (OR = 0.2; 0.26-0.28) and smokeless tobacco pouches (unadjusted OR = 0.5; 0.49-0.53).
The results confirm that education differential exists for tobacco use and its determinants in India. It is recommended that all people of our country should have access to quality education. Policy makers should target uneducated people so as to reverse the tobacco epidemic.
个人的烟草使用情况与教育程度相互关联。受过教育的人更有可能践行健康行为，并且了解烟草使用的危害。本文利用全球成人烟草调查数据（印度全球成人烟草调查），研究印度各地与烟草使用相关的教育差异及其预测因素。
对2009 - 2010年在印度开展的全球成人烟草调查进行二次数据分析。根据研究对象的“烟草消费模式”、“戒烟行为”、“二手烟暴露情况”以及“是否留意烟草制品上的健康警示”，对“文盲”和“有文化”的研究对象的数据进行分析。
与有文化的人相比，吸烟者和使用无烟烟草者更有可能是文盲（吸烟的优势比[OR] = 1.2；使用无烟烟草的OR = 1.5）。值得注意的是，更多文盲在17岁之前就开始吸烟（OR = 1.1；1.02 - 1.26）和养成无烟烟草使用习惯（OR = 1.3；1.21 - 1.44）。文盲尝试戒烟的可能性较小（吸烟 = OR = 0.8；0.79 - 0.94；使用无烟烟草 = OR = 0.7；0.70 - 0.81），并且在不久的将来考虑戒烟的可能性也较小（吸烟 = OR = 0.6；0.59 - 0.71；使用无烟烟草 = OR = 0.6；0.57 - 0.66）。文盲在家中接触二手烟的可能性更大（OR = 1.8；1.7 - 1.9），而留意香烟包装上健康警示的可能性较小（OR = 0.2；0.26 - 0.28），留意无烟烟草袋上健康警示的可能性也较小（未调整的OR = 0.5；0.49 - 0.53）。
结果证实，印度在烟草使用及其决定因素方面存在教育差异。建议我国所有人都能接受优质教育。政策制定者应针对未受过教育的人群，以扭转烟草流行的趋势。
