Abstract
BackgroundNicotine is a highly addictive substance present in tobacco. This study was conducted to assess the level of nicotine dependence among smokers and smokeless tobacco users visiting dental outreach programs of B.P. Koirala Institute of Health Sciences -Dharan, Nepal.MethodsA cross sectional study was conducted from June 2018 to April 2019. A total of 726 people were selected from participants of dental outreach programs of 6 districts using convenience sampling technique. The data collection was done using semi-structured questionnaire through face-to-face interview by a single researcher. History of tobacco use and level of nicotine dependency was measured using Nepali translated and validated form of Fagerström Test for Nicotine Dependence for smoking and smokeless tobacco. The mean age of the tobacco users was 39.55 ± 15.57. Descriptive statistics including the mean, median, percentage, standard deviations and interquartile range were computed. Chi-square test, Fisher’s exact test, univariate and bivariate logistic regression were used where needed.ResultsNicotine dependence (moderate and severe) was found in 80% of smokeless tobacco users and 48% of smokers. Among the smokeless tobacco users, nicotine dependency was found to be more with increase in duration of tobacco use (AOR = 50.25, 95%CI = 3.51–718.62, p = 0.004), low socioeconomic status (AOR = 6.27, 95%CI = 1.30–30.31, p = 0.02), less number of tobacco packets used per day and tried to quit tobacco use in last 1 year. Among smokers nicotine dependency was found to be significantly higher with smoking more than 10 cigarettes per day (AOR = 7.14, 95% CI = 2.00–25.40, p = 0.002).ConclusionsThe study concluded that level of nicotine dependence for both smoking and smokeless tobacco was high among the people visiting dental outreach programs. It is high time to develop a policy to control tobacco use along with creating tobacco cessation centers. Currently, tobacco control program is mostly focusing on smoking. However, it is also important to incorporate smokeless tobacco control at policy level.
Highlights
Nicotine is a highly addictive substance present in tobacco
There are more than 1 billion smokers residing worldwide, out of which around 80% are living in middle-and low-income countries (LICs) like India, Bangladesh and Nepal
Study design A questionnaire based cross sectional study was conducted from June 2018 to April 2019 among people aged more than 18 years who visited outreach programs of the Department of Public Health Dentistry, College of Dental surgery (CODS), BPKIHS - Dharan, Nepal including dental camps
Summary
Nicotine is a highly addictive substance present in tobacco. This study was conducted to assess the level of nicotine dependence among smokers and smokeless tobacco users visiting dental outreach programs of B.P. The world has faced tobacco as an epidemic and is considered as one of the major public health threats to the entire humankind killing more than 8 million people in a year. Most of these deaths are the direct result of tobacco use, 7 million resulting from first hand and 1.2 million from second-hand smoking. Tobacco use is considered as a severe public health threat in the South-East Asia (SEA) Region. This region has almost one quarter of all smokers in the world [3]. The highest rate of ST consumption is in SEA region [4]
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