Ruhil Rohini
Centre for Social Medicine and Community Health (CSMCH), Jawaharlal Nehru University (JNU), New Delhi 110067, India.
Health Policy Open. 2021 Oct 7;2:100053. doi: 10.1016/j.hpopen.2021.100053. eCollection 2021 Dec.
The Global Adult Tobacco Survey (GATS) India 2016-17 has shown that increased regulations over time impacted tobacco use culture, which opened the doors for further regulation, making it an iterative process. But do the 'tobacco control policies' reach till most deprived sections of society? This paper tries to answer this question.
In this paper, the relative reduction in tobacco use prevalence is seen (from 2009 to 10 to 2016-17) across different levels of material deprivation and educational attainment. The relative reduction in prevalence/ use of various forms of smoking and smokeless tobacco products was also studied.Material Deprivation as a new index was computed, where the weightage was given to various variables related to household ownership of various material things as available in data sets of GATS Survey. The recoded variables were then added and further categorised into six levels of material deprivation where Level 1 corresponds to least deprived and Level 6 corresponds to most deprived.The relative reduction in the prevalence of tobacco use was calculated with the formula [(P1-P2)/P1]*100, where P1 is the prevalence of tobacco use (smoking or smokeless) during GATS1 (2009-10), and P2 is the prevalence of tobacco use (smoking or smokeless) during GATS2 (2016-17).
It has been shown that the higher the level of material deprivation, the lesser the relative reduction in the prevalence of tobacco use. The relative reduction in tobacco use was more for higher levels of educational attainment. It has been found that relative reduction is more for smoking products as compared to smokeless tobacco (SLT) products. Khaini and Bidis are emerging as popular products, which are least regulated by existing tobacco control policies.
The reduction in the prevalence of tobacco use from GATS1 to GATS2 is inequitous across levels of material deprivation and levels of educational attainment by individuals. Also, there is a tendency for product substitution among tobacco users.
《2016 - 2017年印度全球成人烟草调查》显示,随着时间推移,监管加强对烟草使用文化产生了影响,这为进一步监管打开了大门,使其成为一个迭代过程。但“烟草控制政策”是否惠及了社会中最贫困的群体呢?本文试图回答这个问题。
在本文中,观察了不同物质匮乏程度和教育水平人群(从2009 - 10年到2016 - 17年)烟草使用流行率的相对下降情况。还研究了各种形式吸烟和无烟烟草产品流行率/使用率的相对下降情况。计算了一个新的物质匮乏指数,该指数根据《全球成人烟草调查》数据集中与家庭拥有各种物质相关的各种变量赋予权重。然后将重新编码的变量相加,并进一步分为六个物质匮乏等级,其中1级对应匮乏程度最低,6级对应匮乏程度最高。烟草使用流行率的相对下降通过公式[(P1 - P2)/P1]*100计算,其中P1是《全球成人烟草调查1》(2009 - 10年)期间烟草使用(吸烟或无烟)的流行率,P2是《全球成人烟草调查2》(2016 - 17年)期间烟草使用(吸烟或无烟)的流行率。
研究表明,物质匮乏程度越高,烟草使用流行率的相对下降幅度越小。教育水平较高人群的烟草使用相对下降幅度更大。研究发现,与无烟烟草产品相比,吸烟产品的相对下降幅度更大。嚼烟和比迪烟正成为受欢迎的产品,现有烟草控制政策对其监管最少。
从《全球成人烟草调查1》到《全球成人烟草调查2》,烟草使用流行率的下降在不同物质匮乏程度和个人教育水平之间是不公平的。此外,烟草使用者中存在产品替代的趋势。