Cross-Sectional Study to Estimate Dependence among Tobacco Smokers Attending a Tertiary Care Government Hospital in Bhavnagar, Western India

Abstract

Background: India is one of the countries where addiction to tobacco smoking is rampant. The consumption of tobacco products is quite high in the Bhavnagar region in the western part of India. Methods: We conducted a cross-sectional hospital-based study among 112 current tobacco smokers aged ≥18 years in April-May 2019 at Sir Takhtsinhji hospital in Bhavnagar. Fourteen smokers from each ward of the hospital were enrolled from eight randomly selected wards. Dependence was assessed using the Fagerstrom Test for Nicotine Dependence, with a score of ≥5 labelled as high dependence. Results: Among the 112 current smokers, 79% (95% confidence interval 70%-85%) were dependent on tobacco smoking. One-fourth of the smokers belonged to the age group of 51-60 years.“Mawa” (a mixture of tobacco, betel nut and lime) was the most commonly consumed smokeless form of tobacco among the smokers. Mean expenditure on tobacco smoking was Indian Rupees 460. Those who had stress had 7 times higher odds (95% CI 3-23) of being dependent on tobacco smoking than their counterparts. Conclusion: We conclude from the study that patients attending our hospital are highly dependent on tobacco smoking. Tobacco cessation activities in the form of provider-initiated counselling and treatment is warranted. Further research should focus on evaluating the implementation modalities and effectiveness of such provider-initiated activities.