Singh Prashant Kumar, Jain Pankhuri, Singh Nishikant, Singh Lucky, Kumar Chandan, Yadav Amit, Subramanian S V, Singh Shalini
Division of Preventive Oncology & Population Health, WHO FCTC Knowledge Hub on Smokeless Tobacco, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, India.
ICMR-National Institute of Medical Statistics, New Delhi, India.
SSM Popul Health. 2022 Oct 4;19:101257. doi: 10.1016/j.ssmph.2022.101257. eCollection 2022 Sep.
This study hypothesises that the presence of a third person during the interaction between the survey investigator and the woman respondent leads to underreporting of smokeless tobacco (SLT) use by Indian women, including pregnant and breastfeeding women.
Cross-sectional data from the National Family Health Survey conducted in 2015-16 was analysed for SLT use among women aged 15-49. Multivariate logistic regression examined the odds of SLT use reporting by women respondents in the presence of their husbands and other male or female adults.
SLT use reporting by women significantly varied by the presence of someone during the interview. The analysis shows that the odds of reporting SLT use among women who were neither pregnant nor lactating was 20.6% lower when they were interviewed in the presence of their husbands than when they were interviewed alone. Similarly, compared to those interviewed alone, the odds of women reporting SLT use was 16.5% lower among pregnant and breastfeeding women interviewed in the presence of any adult female. The odds of women under-reporting SLT use were higher in Central and Western India.
This study argues that the current survey estimates misconstrue the authentic prevalence of tobacco use among women in India, including pregnant and lactating women. Due to social desirability or the presence of a third person during the survey interview, those respondents who do not report their tobacco use status are also more likely to forego essential support for successful tobacco cessation. Survey methodology must be strengthened to avert the presence of a third person during the interview to ensure better reporting and population health estimates.
本研究假设，在调查员与女性受访者互动过程中若有第三人在场，会导致印度女性（包括孕妇和哺乳期妇女）对无烟烟草使用情况的报告不足。
对2015 - 16年进行的全国家庭健康调查中的横断面数据进行分析，以了解15 - 49岁女性的无烟烟草使用情况。多变量逻辑回归分析了女性受访者在丈夫及其他成年男性或女性在场时报告无烟烟草使用情况的几率。
女性报告无烟烟草使用情况因访谈时是否有他人在场而有显著差异。分析表明，非孕期和非哺乳期女性在丈夫在场时接受访谈，报告使用无烟烟草的几率比单独接受访谈时低20.6%。同样，与单独接受访谈相比，有成年女性在场时接受访谈的孕妇和哺乳期妇女报告使用无烟烟草的几率低16.5%。印度中部和西部女性少报无烟烟草使用情况的几率更高。
本研究认为，当前的调查估计误解了印度女性（包括孕妇和哺乳期妇女）烟草使用的真实流行率。由于社会期望或调查访谈时有第三人在场，那些未报告其烟草使用状况的受访者也更有可能放弃成功戒烟所需的必要支持。必须加强调查方法，避免访谈时有第三人在场，以确保更好的报告情况和对人群健康的估计。
