Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK.
Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Greece.
Nicotine Tob Res. 2021 Oct 7;23(11):1816-1820. doi: 10.1093/ntr/ntab084.
Improving understanding of the epidemiology of dual and poly-tobacco product use is essential for tobacco control policy and practice. The present study aimed to systematically review existing epidemiologic evidence on current dual and poly-tobacco use among adults globally.
We systematically searched online databases for studies published up to June 30, 2020. We included quantitative studies with measures of nationally representative prevalence of current dual or poly-tobacco use among adults. Prevalence estimates for each country were extracted manually and stratified by WHO regions and World Bank income classifications.
Twenty studies with nationally representative prevalence data on current dual or poly-tobacco use in the adult population across 48 countries were included. Definitions of dual and poly-tobacco use varied widely. Prevalence of dual and poly-tobacco use was higher in low- and lower-middle-income countries compared to other higher-income countries. Current dual use of smoked and smokeless tobacco products among males ranged from 0.2% in Ukraine (2010) and Mexico (2009) to 17.9% in Nepal (2011). Poly-tobacco use among males ranged from 0.8% in Mexico (2009) and 0.9% in Argentina (2010) to 11.4% in the United Kingdom and 11.9% in Denmark in 2012. Dual tobacco use was generally higher in South-East Asia; poly-tobacco use was prevalent in Europe as well as in South-East Asia.
This is the first systematic review of the prevalence estimates of dual and poly-tobacco use among adults globally. The results of the current study could significantly help health policy makers to implement effective tobacco control policies.
This study demonstrates that dual/poly-tobacco use is common in many countries of the world, and highlights the need for in-depth exploration of this field in future studies, especially in high prevalence regions such as South-East Asian and European countries. In light of this, the global tobacco control community and health authorities should also agree upon a consistent operational definition of dual and poly-tobacco use to propel research and improve surveillance of dual/poly-use in health surveys for better communication and understanding of these phenomena.
了解双重和多种烟草制品使用的流行病学情况对于烟草控制政策和实践至关重要。本研究旨在系统综述全球成年人中当前双重和多种烟草制品使用的现有流行病学证据。
我们系统地检索了截至 2020 年 6 月 30 日在线数据库中的研究。我们纳入了具有成年人当前双重或多种烟草制品使用的全国代表性流行率测量值的定量研究。手动提取每个国家的流行率估计值，并按世卫组织区域和世界银行收入分类进行分层。
纳入了 48 个国家的 20 项具有成年人当前双重或多种烟草制品使用的全国代表性流行率数据的研究。双重和多种烟草制品使用的定义差异很大。与其他高收入国家相比，低收入和中低收入国家的双重和多种烟草制品使用流行率更高。男性中使用吸烟和无烟烟草制品的双重使用率范围从乌克兰（2010 年）和墨西哥（2009 年）的 0.2%到尼泊尔（2011 年）的 17.9%。男性中的多种烟草制品使用率范围从墨西哥（2009 年）和阿根廷（2010 年）的 0.8%到英国和丹麦 2012 年的 11.4%和 11.9%。东南亚的双重烟草使用通常较高；欧洲以及东南亚的多种烟草使用也很普遍。
这是首次对全球成年人中双重和多种烟草制品使用的流行率估计进行的系统综述。本研究的结果可能会极大地帮助卫生政策制定者实施有效的烟草控制政策。
本研究表明，双重/多种烟草使用在世界许多国家都很普遍，这突出表明需要在未来研究中深入探讨这一领域，特别是在东南亚和欧洲等高流行率地区。有鉴于此，全球烟草控制界和卫生当局也应该就双重和多种烟草制品使用的一致操作定义达成一致，以推动研究并改善健康调查中对双重/多用途的监测，以便更好地交流和理解这些现象。
