Awareness of Tobacco-Related Health Harms among Vulnerable Populations in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey.

Pete Driezen,Abu Abdullah,Anne Quah,Geoffrey Fong,Steve Xu,Mary Thompson,A Hussain,Nigar Nargis

doi:10.3390/ijerph13090848

Abstract

This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control.

Highlights

Social determinants of health, including income, education, occupation and residential location, are associated with cigarette smoking and tobacco use [1,2,3,4,5,6,7,8,9]
Using socio-demographic proxy measures of vulnerability, this study demonstrated that certain population groups are less knowledgeable of tobacco’s harmful effects, including women, the illiterate and residents of urban slums
This study relied on cross-sectional data, these findings are consistent with the notion that lower health literacy may prevent vulnerable groups from taking measures to protect their health

Summary

Introduction

Social determinants of health, including income, education, occupation and residential location, are associated with cigarette smoking and tobacco use [1,2,3,4,5,6,7,8,9]. In high-income countries (HICs), smoking is more prevalent in low socioeconomic groups than high socioeconomic groups [10,11,12,13]. Res. Public Health 2016, 13, 848; doi:10.3390/ijerph13090848 www.mdpi.com/journal/ijerph

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