Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India.
Department of Public Health and Community Medicine, Central University of Kerala, Kasaragod, Kerala, India.
Eur J Obstet Gynecol Reprod Biol. 2023 Oct;289:79-84. doi: 10.1016/j.ejogrb.2023.08.377. Epub 2023 Aug 23.
India accounts for over 67% of chewing tobacco users globally and more than 50 million women in India chew tobacco. Chewing tobacco is documented to have negative effects on health of mother and foetus. This research was conducted to study the trends in chewing tobacco use among pregnant women in India, and identify factors associated with chewing tobacco use among pregnant women.
We analyzed micro-data from two representative national surveys i.e., National Family Health Survey (NFHS)-4 (2015-16) & NFHS-5 (2019-21). A sample of 32,428 & 28,408 pregnant women were extracted from NFHS-4 & NFHS-5 respectively. Weighted prevalence and 95% confidence levels of chewing tobacco use were computed. State wide comparisons in chewing tobacco use were made. Employing binary logistic regression, adjusted odds ratios (AOR) were computed to identify factors associated with chewing tobacco use.
From NFHS-4 to 5 the prevalence of chewing tobacco use among pregnant women decreased from 4.0%(95% CI = 3.9-4.0) to 2.3%(95% CI = 2.2-2.4) respectively indicating a relative reduction of 42.5%. The highest prevalence remains to be in north-eastern India at 13.0%. Belonging to north-eastern region AOR = 7.0(95 %CI = 6.2-7.9), no-education AOR = 13.2(95 %CI = 10.5-16.5), poorest wealth index AOR = 6.7(95 %CI = 5.6-8.0) and belonging to scheduled tribe AOR = 2.6(95 %CI = 2.4-2.9) was significantly associated with chewing tobacco use among pregnant women.
From NFHS-4 to 5, chewing tobacco use during pregnancy has shifted more towards socio-economically vulnerable population. Targeted approaches with accessible and affordable tobacco cessation advice integrated to primary healthcare system are needed.
印度的嚼烟使用者占全球的 67%以上，印度有超过 5000 万女性嚼烟。嚼烟已被证明对母婴健康有负面影响。本研究旨在研究印度孕妇嚼烟使用趋势，并确定与孕妇嚼烟使用相关的因素。
我们分析了两项具有代表性的全国性调查的微观数据，即国家家庭健康调查（NFHS）-4（2015-16 年）和 NFHS-5（2019-21 年）。从 NFHS-4 和 NFHS-5 中分别提取了 32428 和 28408 名孕妇的样本。计算了嚼烟使用的加权流行率和 95%置信区间。进行了州际间嚼烟使用的比较。采用二项逻辑回归，计算调整后的优势比（AOR），以确定与嚼烟使用相关的因素。
从 NFHS-4 到 5，孕妇嚼烟使用的流行率从 4.0%（95%CI=3.9-4.0）降至 2.3%（95%CI=2.2-2.4），相对减少了 42.5%。最高的流行率仍然在印度东北部，为 13.0%。属于东北部地区的 AOR=7.0（95%CI=6.2-7.9），未受过教育的 AOR=13.2（95%CI=10.5-16.5），最贫穷的财富指数 AOR=6.7（95%CI=5.6-8.0），属于在册种姓的 AOR=2.6（95%CI=2.4-2.9），与孕妇嚼烟使用显著相关。
从 NFHS-4 到 5，怀孕期间嚼烟使用更多地转向了社会经济弱势群体。需要通过初级卫生保健系统提供可及且负担得起的戒烟建议，采取有针对性的方法。
