Rupani Mihir Prafulbhai, Parikh Khushali Dharmesh, Kakadia Mili J, Pathak Meha M, Patel Malay R, Shah Manav A
Department of Community Medicine, Government Medical College, Bhavnagar, Gujarat 364001, India.
Department of Pathology, B.J. Medical College and Civil Hospital, Ahmedabad, Gujarat, India.
Natl Med J India. 2019 May-Jun;32(3):137-140. doi: 10.4103/0970-258X.278686.
Data are sparse on smokeless tobacco (SLT) use in Bhavnagar. We assessed the prevalence and awareness of and expenditure on SLT use in Bhavnagar.
We conducted a community-based, cross- sectional study in an urban slum of Bhavnagar on a sample of 260 SLT users for a period of three months in 2017.
The prevalence of SLT use in Bhavnagar was 27.3% (95% CI 25%-30%). Mawa, a preparation of tobacco flakes mixed with areca nut and lime, was the most commonly chewed form of tobacco; commonly kept in the buccal mucosa. The mean age ofstarting SLT use was 25 years; the mean number of years since chewing was 15 years; the mean time tobacco was kept in the mouth per consumption was 5 minutes and the mean number of packets of tobacco consumed per day was five. The mean expenditure on SLT use per month was ?536. All SLT users were aware that tobacco consumption led to oral cancer. Peer influence was the most common (75%) reason for starting SLT use, and addiction was the most common (74%) reason for its continued use. Among SLT users, 47% had made at least one attempt to quit; of them, 98% had tried self-control for quitting but did not succeed. The most common (72%) reason given by those not able to quit (n=119) was addiction to SLT use. Among the 260 study participants, 72% had read the warnings on packets of tobacco; 59% wished to chew tobacco even after reading the warnings and 62% opined on banning the sale and consumption of tobacco. Ninety-two per cent of SLT users were not comfortable with the idea that imitating them, their children too would start chewing tobacco.
Every third person in the urban slum of Bhavnagar was a SLT user. Even though SLT users knew about the harmful effects of tobacco, only a handful were able to quit due to addiction to it. This burden on health services, in addition to the expenditure on purchase of tobacco, requires a comprehensive tobacco cessation programme at the community level.
关于巴夫那加尔无烟烟草（SLT）使用情况的数据稀少。我们评估了巴夫那加尔无烟烟草使用的流行率、知晓率及相关支出。
2017年，我们在巴夫那加尔的一个城市贫民窟对260名无烟烟草使用者进行了为期三个月的基于社区的横断面研究。
巴夫那加尔无烟烟草的使用率为27.3%（95%置信区间25%-30%）。马瓦是最常咀嚼的烟草形式，它是由烟草薄片与槟榔果和石灰混合制成，通常含于颊黏膜处。开始使用无烟烟草的平均年龄为25岁；咀嚼烟草的平均时长为15年；每次咀嚼时烟草在口中停留的平均时间为5分钟，每天消耗的烟草平均包数为5包。每月无烟烟草使用的平均支出为536卢比。所有无烟烟草使用者都知晓烟草消费会导致口腔癌。同伴影响是开始使用无烟烟草最常见的原因（75%），而上瘾是继续使用的最常见原因（74%）。在无烟烟草使用者中，47%至少尝试过一次戒烟；其中，98%曾尝试自我控制戒烟但未成功。未能戒烟者（n = 119）给出的最常见原因（72%）是对无烟烟草使用上瘾。在260名研究参与者中，72%读过烟草包装上的警示；59%即使读过警示仍希望咀嚼烟草，62%认为应禁止烟草销售和消费。92%的无烟烟草使用者不希望自己的孩子因模仿他们而开始咀嚼烟草。
巴夫那加尔城市贫民窟每三个人中就有一个是无烟烟草使用者。尽管无烟烟草使用者知晓烟草的有害影响，但由于对其成瘾，只有少数人能够戒烟。除了购买烟草的支出外，这对医疗服务造成的负担需要在社区层面开展全面的戒烟项目。
