Karmakar Diptarka, Banerjee Amitav
Department of Community Medicine, Dr. DY Patil Medical College, Hospital and Research Centre, Dr. DY Patil Vidyapeeth, Pune, Maharashtra, India.
Ind Psychiatry J. 2017 Jul-Dec;26(2):128-133. doi: 10.4103/ipj.ipj_70_17.
Anti-tobacco policies are focused on curbing smoking. Less attention is given to the use of smokeless tobacco use. This raises the concern whether these policies lead to increased use of smokeless tobacco use. The present study addresses this issue.
A stratified random sample of 399 participants over 18 years and both genders were part of this cross-sectional study. They included an interview of urban and rural residents by house-to-house survey including outpatients, inpatients, and college students. Information was collected by face-to-face interview on a standard instrument for recording tobacco use. Additional questions were added to elicit switch from smoking to smokeless forms of tobacco. In-depth interviews were also held with some tobacco vendors.
Data were summarized in percentages and with mean and standard deviation. Chi-square and two sample -tests were used to explore associations.
Prevalence of smokeless tobacco use was 36.59% (95% confidence interval: 31.97%-41.41%). Smokeless tobacco use was highest in rural community at 60.20% compared to urban community in which it was 40%. Unskilled workers had the highest prevalence of smokeless tobacco use at 48.57% compared to lowest prevalence among professionals (12.50%). Years of schooling was inversely related to both smoking and smokeless tobacco use. Prevalence of smoking at 20.55% was much less than use of smokeless tobacco use. Awareness of adverse health effects and ban in public places were the main reasons for quitting smoking. About 10% of those who quitted smoking took smokeless tobacco.
There was a tendency among tobacco users to switch over to smokeless tobacco use due to awareness of health effects and ban on smoking in public places. A much higher prevalence of smokeless tobacco use compared to smoking suggests that the problem of smokeless tobacco use is receiving less attention from policymakers vis-à -vis smoking control policies.
反烟草政策主要侧重于遏制吸烟。对无烟烟草使用的关注较少。这引发了人们对这些政策是否会导致无烟烟草使用增加的担忧。本研究探讨了这一问题。
本横断面研究纳入了399名18岁以上的参与者，采用分层随机抽样，涵盖男女两性。通过逐户调查对城乡居民进行访谈，包括门诊患者、住院患者和大学生。通过面对面访谈，使用标准工具记录烟草使用情况。还增加了一些问题以了解从吸烟转向无烟烟草形式的情况。同时也对一些烟草摊贩进行了深入访谈。
数据以百分比、均值和标准差进行汇总。使用卡方检验和两样本检验来探索关联。
无烟烟草使用率为36.59%（95%置信区间：31.97%-41.41%）。农村社区的无烟烟草使用率最高，为60.20%，而城市社区为40%。非技术工人的无烟烟草使用率最高，为48.57%，而专业人员中的使用率最低（12.50%）。受教育年限与吸烟和无烟烟草使用均呈负相关。吸烟率为20.55%，远低于无烟烟草使用率。对健康不良影响的认知和公共场所禁烟是戒烟的主要原因。约10%戒烟者开始使用无烟烟草。
由于对健康影响的认知和公共场所禁烟，烟草使用者有转向使用无烟烟草的趋势。无烟烟草使用率远高于吸烟率，这表明与吸烟控制政策相比，无烟烟草使用问题受到政策制定者的关注较少。
