School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India.
Datta Meghe Institute of Higher Education and Research, Sawangi, Maharashtra, India.
Asian Pac J Cancer Prev. 2023 Nov 1;24(11):3773-3781. doi: 10.31557/APJCP.2023.24.11.3773.
Gutkha or Paan masala with tobacco is commonly used smokeless tobacco product in India. Given the restrictions on advertisement and promotion of Gutkha and the necessity of warning labels on tobacco products, the tobacco industry has popularised paan masala without tobacco as a surrogate product. Paan masala itself is harmful for health but remains beyond scope of current tobacco control policies. It was important to understand prevalence and determinants of its use (with or without tobacco).
Data from the Global Adult Tobacco Survey (GATS)-2, India was used to estimate prevalence of paan masala use (with or without tobacco) in India. Multi-nominal regression and logistic regression were used to calculate risk ratios and odds ratios.
The prevalence of any form of paan masala was 12.1% among adults in India. Prevalence was higher among males (17.8%) than females (6.0%), aged 25-44 years (14.5%) than those aged 65 years or above (9.0%). Relative risk ratio (RRR) for Paan masala with tobacco was significantly high among those with no formal schooling (RRR:2.00) and among those in poorest wealth quintiles (RRR:1.26). While, RRR were lower for Paan masala use without tobacco among those with no formal schooling (RRR:0.95) and among poorest wealth quintiles (RRR:0.78). Region-wise AOR were highest for North-East (AOR:4.80) and Central regions (AOR:4.76) compared to South India.
The prevalence of paan masala use is high in India. Persons belonging to lower socioeconomic status or having no formal schooling have higher risk of consuming paan masala with tobacco. However, persons from higher wealth quintiles or having formal schooling had higher risk of use of paan masala without tobacco. These findings need careful attention of policy makers and law enforcers as it indicates different marketing strategies might have adopted by industry to target these two mutually exclusive population groups.
Gutkha 或 Paan 调味烟草是印度常用的无烟烟草制品。鉴于 Gutkha 的广告和促销限制以及烟草制品必须使用警告标签，烟草行业已经将不含烟草的 Paan 调味烟草作为替代产品推广开来。Paan 调味烟草本身对健康有害，但仍不在当前烟草控制政策的范围内。了解其（含或不含烟草）使用的流行率和决定因素非常重要。
使用来自印度全球成人烟草调查（GATS）-2 的数据来估计印度使用 Paan 调味烟草（含或不含烟草）的流行率。使用多项名义回归和逻辑回归计算风险比和优势比。
印度成年人中任何形式的 Paan 调味烟草使用率为 12.1%。男性（17.8%）高于女性（6.0%），25-44 岁年龄组（14.5%）高于 65 岁及以上年龄组（9.0%）。无正规教育的人（RRR：2.00）和最贫穷的五个财富阶层（RRR：1.26）中，含烟草的 Paan 调味烟草的相对风险比（RRR）显著较高。而在无正规教育的人群中，不含烟草的 Paan 调味烟草使用率较低（RRR：0.95）和最贫穷的五个财富阶层（RRR：0.78）。与印度南部相比，东北地区（AOR：4.80）和中部地区（AOR：4.76）的区域 AOR 最高。
印度的 Paan 调味烟草使用率很高。社会经济地位较低或没有正规教育的人更有可能消费含烟草的 Paan 调味烟草。然而，来自较高财富阶层或受过正规教育的人更有可能使用不含烟草的 Paan 调味烟草。这些发现需要政策制定者和执法者的密切关注，因为这表明行业可能针对这两个相互排斥的人群群体采用了不同的营销策略。
