Abstract
Despite Pakistan's stringent tobacco control policy, its effective implementation has always been a challenge, leading to rising tobacco consumption. The aim of the study is to determine the prevalence of tobacco consumption and associated risk factors in the adult population of deprived urban areas. A community-based, cross-sectional survey was conducted from February to July 2019, comprising 607 adults residing in the urban squatter settlement of Lahore using a standardized questionnaire, the WHO STEPwise approach. The outcome was current use of tobacco and/or smokeless tobacco daily. Multivariable logistic regression was applied to determine factors associated with smoking and smokeless tobacco consumption. Among 607 participants, about 64% were females, 49.3% were illiterate, 64.9% were currently unemployed, and 47.1% belonged to the low-income group. The prevalence of tobacco smoke was 10.5% (95% CI: 8.07-12.93), and smokeless tobacco consumption was 8.6% (95% CI: 6.38-10.82). Multivariable logistic regression found that smokeless tobacco was more likely among the aged 50-59 years (AOR=4.1; 95% CI: 1.1-13.8) and unemployed (AOR=3.6; 95% CI: 1.1-12.2). Whereas tobacco smoking was more likely among the aged 30-39 years (AOR=5.5; 95% CI: 1.8-16.7), Urdu ethnicity (AOR=2.9; 95% CI: 1.2-7.3), unemployed (AOR=6.6; 95% CI: 2.9-14.9), and never exposed to any media (AOR=3.2; 95% CI: 1.8-17.4). Participants exposed to health warnings were less likely to smoke (AOR=0.02; 95% CI: 0.01-0.05). This study reports a high prevalence of tobacco consumption among adults and calls for effective policy implementation using a multi-pronged approach, including health professionals and media, to spread awareness about the harmful effects of tobacco and endorsement of health warnings on tobacco packaging.
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