Irshad Hammad Atif, Raja Sajjan, Jehanzeb Hamzah, Shaikh Wamiq Ali, Saleem Umair, Malik Shahzil Abdur Rehman, Shahzad Akmal, Shaikh Mamoon, Iqbal Nousheen, Khan Javaid Ahmed
Medical College, Aga Khan University, Karachi, 74800, Pakistan.
Ziauddin University, Karachi, Pakistan.
J Health Popul Nutr. 2025 Jan 24;44(1):19. doi: 10.1186/s41043-025-00754-0.
Smokeless tobacco (SLT) encompasses products that are not burnt but instead consumed orally or nasally. One-third of tobacco is consumed in the smokeless form in South Asia. Despite its widespread usage, there has been limited empirical research on the prevalence and factors influencing SLT consumption in Pakistan. This study aimed to provide an assessment of SLT knowledge, attitudes, and usage in Pakistan.
Using an online questionnaire, a cross-sectional survey was conducted across Pakistan. Convenience sampling was used to disseminate, and expert approval was sought followed by a pilot study to validate the questionnaire. A comprehensive questionnaire was developed using elements from the Global Adult Tobacco Survey and other tools which had previously been utilized within Pakistan. Participants' responses were described using descriptive statistics, and SPSS version 26 was used to perform linear and logistic regression. A p-value of less than 0.05 was considered statistically significant.
Data was collected from 1,195 participants among which 85.86% of participants had heard of SLTs prior to the survey. Sex, province, household income and previous doctor visits were significant determinants to product knowledge through which 72.55% agreed that these products can lead to serious illnesses but 30% noted a lack of knowledge on legality. General attitudes agreed that it makes one feel unwell (44.1%), gives a sense of guilt (43.85%) and more research is needed on it (54.39%). Negative health effects were the biggest deterrent from pursuing these products for 60.33% of participants. Among significant factors influencing the use of SLTs, the greatest odds of use were found with use as an alternative to cigarettes (OR 4.45) and secondly, due to its availability in a liked flavor (OR 2.27). About 31% reported to have used the product once, with 69.82% of current users expressing a desire to quit.
Although adequate knowledge and aligning attitudes exist for SLTs, light is shed in the face of a sustaining public health problem. We offer important insights that can guide the creation of focused interventions meant to lower SLT use, and the health hazards associated with it in the Pakistani community by highlighting important myths, incentives, and deterrents.
无烟烟草（SLT）包括不燃烧而是通过口腔或鼻腔吸食的产品。在南亚，三分之一的烟草是以无烟形式消费的。尽管其使用广泛，但在巴基斯坦，关于无烟烟草消费的流行情况及影响因素的实证研究有限。本研究旨在对巴基斯坦的无烟烟草知识、态度和使用情况进行评估。
通过在线问卷在巴基斯坦各地进行了一项横断面调查。采用便利抽样进行问卷分发，并在寻求专家批准后进行了预试验以验证问卷。使用全球成人烟草调查的要素和巴基斯坦此前使用过的其他工具编制了一份综合问卷。使用描述性统计描述参与者的回答，并使用SPSS 26版进行线性和逻辑回归分析。p值小于0.05被认为具有统计学意义。
共收集了1195名参与者的数据，其中85.86%的参与者在调查前听说过无烟烟草产品。性别、省份、家庭收入和之前看医生的情况是产品知识的重要决定因素，72.55%的人认为这些产品会导致严重疾病，但30%的人指出对其合法性缺乏了解。总体态度方面，44.1%的人认为它会让人感觉不适，43.85%的人感到内疚，54.39%的人认为需要对其进行更多研究。60.33%的参与者认为负面健康影响是使用这些产品的最大阻碍。在影响无烟烟草使用的重要因素中，将其作为香烟替代品使用的可能性最大（比值比4.45），其次是因其有喜欢的口味（比值比2.27）。约31%的人报告曾使用过该产品一次，69.82%的当前使用者表示希望戒烟。
尽管对无烟烟草有足够的了解且态度一致，但面对持续存在的公共卫生问题仍需关注。我们提供了重要见解，通过强调重要的误解、诱因和阻碍因素，可指导制定有针对性的干预措施，以减少巴基斯坦社区的无烟烟草使用及其相关健康危害。
