Tobacco use and nicotine dependency in a cross-sectional representative sample of 18,018 individuals in Andaman and Nicobar Islands, India

Sathya Prakash Manimunda,Kandavelu Thennarusu,Kasturi S Pesala,Dhanasekara Pandian,Attayuru Purushottaman Sugunan,Panniyammakal Jeemon,Vivek Benegal,Nagalla Balakrishna

doi:10.1186/1471-2458-12-515

Abstract

BackgroundData on prevalence, pattern of tobacco use, proportion of population dependent on nicotine and their determinants are important for developing and implementing tobacco control strategies. The aim of the study was to estimate the prevalence and determinants of tobacco use and nicotine dependency.MethodsA cross-sectional survey among a representative sample of 18,018 individuals in the age group of >=14 years was conducted in the Union Territory of Andaman and Nicobar Islands during 2007–09. A structured questionnaire, a modified version of an instrument which was used successfully in several multi-country epidemiological studies of the World Health Organisation, was used to survey individual socio-demographic details, known co-morbid conditions, tobacco use and alcohol use. Fagerström Test for Nicotine Dependence (FTND) was used to estimate nicotine dependence.ResultsThe response rate of our survey was 97% (18,018/18,554). Females (n = 8,888) were significantly younger than males (34.3 + 14.6 Vs 36.2 + 15.4 years). The prevalence of current tobacco use in any form was 48.9% (95% CI: 48.2–49.6). Tobacco chewing alone was prevalent in 40.9% (95% CI: 40.1–41.6) of the population. While one tenth of males (9.7%, 95% CI: 9.1–10.4) were nicotine dependent, it was only 3% (95% CI: 2.7–3.4) in females. Three fourth of the tobacco users initiated use of tobacco before reaching 21 years of age. Age, current use of alcohol, poor educational status, marital status, social groups, and co-morbidities were the main determinants of tobacco use and nicotine dependence in the population.ConclusionThe high prevalence of tobacco use especially the chewing form of tobacco in the Union Territory of Andaman and Nicobar Islands and the differences in prevalence and pattern of tobacco use and nicotine dependency observed across subgroups warrants implementation of culturally specific tobacco control activities in this population.

Highlights

Data on prevalence, pattern of tobacco use, proportion of population dependent on nicotine and their determinants are important for developing and implementing tobacco control strategies
The survey was carried out in the populations of archipelago which fall into one of five prominent social groupings, namely: 1] The Nicobarese tribal people, who constitute the indigenous population of the archipelago; 2] The Ranchi tribes’ (Ranchis) tribes-re-settled tribal populations from Jharkhand region; 3] People from the mainland who settled in the islands before 1942; 4] Later settlers mainly from Bangladesh, rehabilitated by Government of India under various rehabilitation schemes; 5] nonsettlers belonging to Tamil, Telugu, and Malayalam native speaking people from the mainland temporarily living in the islands for business and employment
While one tenth of males (9.7%, 95% CI: 9.1–10.4) were nicotine dependent, it was only 3% in females (

Summary

Introduction

Pattern of tobacco use, proportion of population dependent on nicotine and their determinants are important for developing and implementing tobacco control strategies. Several nationwide prevalence studies like the National Family Health Survey (NFHS) and Global Adult Tobacco Survey (GATS) report proportion of population using tobacco products in India [3,4], nicotine dependence rates are not well documented. Both the NFHS and GATS did not cover the Union Territory (UT) of Andaman and Nicobar Islands.

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