Mbulo Lazarous, Palipudi Krishna M, Smith Tenecia, Yin Shaoman, Munish Vineet G, Sinha Dhirendra N, Gupta Prakash C, Swasticharan Leimapokpam
Global Tobacco Control Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, United States.
World Health Organization Country Office, New Delhi, India.
Tob Prev Cessat. 2020 May 4;6:28. doi: 10.18332/tpc/119053. eCollection 2020.
Bidis are the most commonly smoked tobacco product in India. Understanding bidi smoking is important to reducing overall tobacco smoking and health-related consequences in India. We analyzed 2009-2010 and 2016-2017 Global Adult Tobacco Survey (GATS) India data to examine bidi smoking and its associated sociodemographic correlates and perceptions of dangers of smoking.
GATS is a nationally representative household survey of adults aged ≥15 years, designed to measure tobacco use and tobacco control indicators. Current bidi smoking was defined as current smoking of one or more bidis during a usual week. We computed bidi smoking prevalence estimates and relative change during 2009-2010 and 2016-2017. Used pooled multilevel logistic regression to identify individual-level determinants of bidi smoking and neighborhood-level and state-level variations.
Overall, 9.2% and 7.7% of adults smoked bidis in India during 2009-2010 and 2016-2017, respectively, reflecting 16.4% significant relative decline. In pooled analysis, male, older age, rural residence, lower education level, lower wealth index, less knowledge about harms of smoking, and survey year were associated with increased odds of bidi smoking. Results also showed variance in odds of smoking bidis is associated with neighborhood (15.9%) and state (31.8%) level.
Higher odds of bidi smoking were found among males, older age groups, and among those with lower socioeconomic status. Accordingly, health education interventions designed for these groups across India and other population-level interventions, such as WHO recommendation on increasing price on tobacco products, could help reduce bidi smoking. In addition, state/neighborhood-specific interventions could also help address differential bidi smoking across India.
比迪烟是印度最常吸食的烟草产品。了解比迪烟吸食情况对于减少印度总体吸烟率及与健康相关的后果至关重要。我们分析了2009 - 2010年和2016 - 2017年全球成人烟草调查（GATS）印度的数据，以研究比迪烟吸食情况及其相关的社会人口统计学关联因素以及对吸烟危害的认知。
GATS是一项针对15岁及以上成年人的具有全国代表性的家庭调查，旨在衡量烟草使用情况和烟草控制指标。当前比迪烟吸食定义为在通常一周内吸食一支或多支比迪烟。我们计算了2009 - 2010年和2016 - 2017年期间比迪烟吸食流行率估计值及相对变化。采用汇总的多水平逻辑回归来确定比迪烟吸食的个体层面决定因素以及邻里层面和邦层面的差异。
总体而言，2009 - 2010年和2016 - 2017年期间，印度分别有9.2%和7.7%的成年人吸食比迪烟，相对下降了16.4%。在汇总分析中，男性、年龄较大、农村居住、教育水平较低、财富指数较低、对吸烟危害了解较少以及调查年份与比迪烟吸食几率增加相关。结果还显示，吸食比迪烟几率的差异与邻里层面（15.9%）和邦层面（31.8%）有关。
在男性、年龄较大群体以及社会经济地位较低者中，比迪烟吸食几率较高。因此，针对印度这些群体开展的健康教育干预措施以及其他人群层面的干预措施，如世界卫生组织关于提高烟草产品价格的建议，可能有助于减少比迪烟吸食。此外，邦/邻里层面的特定干预措施也有助于解决印度各地比迪烟吸食情况的差异。
