Smokeless Tobacco Consumption Research Articles

Economy-wide impact of a reduction in tobacco use in India

BackgroundPublic policy measures aimed at regulating tobacco use should consider the net gains for the nation, as the tobacco sector contributes to employment and tax revenue while also imposing substantial...

Exploring epidemiological maternal risk factors associated with the cases of birth asphyxia: a study at civil hospital, Ahmedabad

Background: Maternal health is crucial for fetal growth; certain risk factors were identified which can affect development. Birth asphyxia, a preventable condition among the newborns, which can be managed with appropriate care during pregnancy, delivery, and post-delivery. This study aimed to identify maternal risk factors for birth asphyxia in newborns. Early recognition and timely preventive measures can lower the morbidity and mortality linked to asphyxia. Methods: The cross-sectional study was conducted over a one-year period. The mothers of asphyxiated newborns were selected for the study. Data was collected using a pretested, semi-structured questionnaire and analyzed using MS Excel and SPSS 26 Results: 150 mothers were selected for the study based on the inclusion criteria. Among the maternal risk factors, late registered pregnancies and the mother who suffered prolonged labor were significantly associated with the severity of asphyxia. Newborn of pregnant women who had history of consumption of smokeless tobacco had significantly more risk of developing hypoxic ischemic encephalopathy (HIE). Conclusions: To improve neonatal outcomes, focusing on antenatal pediatrics is essential. Early detection and referral of maternal risk factors such as lack of ANC visits, consumption of smokeless tobacco and maternal anemia can prevent adverse outcomes and ensure better care for newborns.

Increasing prevalence of smokeless tobacco consumption in the Northeastern region of India: An analysis of two rounds of Global Adult Tobacco Survey I and II (2009–10 and 2016–17)

Abstract: INTRODUCTION: Tobacco claims over 8 million lives, with over 80% of the 1.3 billion users residing in low- and middle-income nations. India ranks highest in the proportion of users globally, notably in the Northeastern states. This paper aims to analyze the overall trends of smoking and smokeless tobacco (SLT) in the Northeast Region (NER) of India between the two rounds of the Global Adult Tobacco Survey (GATS) while analyzing the factors influencing tobacco used in the context of the region. MATERIALS AND METHODS: Descriptive analysis, estimation, and comparison of the prevalence of smoking and SLT were conducted for both rounds of GATS. The Chi-square test was employed to examine the association between variables such as gender, age, residence, education level, occupation, marital status, and caste while adjusting for GATS weight. RESULTS: The prevalence of smoking tobacco in GATS-II in NER is 19.3%, a decrease of 12% from GATS-I. While the use of manufactured cigarettes decreased by 33.7%, the use of bidi smoking and rolled tobacco in paper/leaf increased by 15.9% and 9.2%, respectively. The prevalence of SLT in GATS-II was 40.5%, a significant increase of 17% from GATS-I. While both genders exhibited increased tobacco usage, females experienced a particularly significant rise (18%) between the two survey rounds. No formal schooling, gender, rural residence, older age group, and occupation were significant factors in influencing the increased use of SLT. CONCLUSION: The prevalence of SLT consumption in the NER is on the rise, even as overall trends indicate a decrease in smoking tobacco. To effectively address this issue, tobacco should be integrated as a crosscutting concern across all levels of health programs. Multisectoral collaborations involving communities and schools can achieve regulatory and meaningful reductions in tobacco use.

Effects of Smokeless Tobacco on Oral Health: A Cross-Sectional Study.

Smokeless tobacco (SLT) consumption poses a significant global public health challenge because of its adverse effects on oral health. Although the detrimental impact of SLT on oral tissues is well-documented, understanding its multifaceted effects is essential for effective prevention and intervention strategies. This study aimed to comprehensively assess the impact of SLT on oral health, focusing on various clinical parameters and their differences between placement and non-placement sites of SLT. A cross-sectional study involving 528 habitual users of SLT was conducted. Clinical parameters included the plaque index (PI), gingival index (GI), gingival bleeding index (GBI), gingival recession (GR), and probing depth (PD). Oral mucosal changes at SLT placement sites have also been reported. Statistical analysis was performed to compare parameters between the placement and non-placement sites. The study involved 528 subjects, mostly male (82%) and aged 21-40 years (mean±SD=31.14±9.10), habitual users of SLT. Prevalent SLT types included tobacco with betel nuts/masala/gutkha (59.9%) and tobacco with lime (54.5%). Significant differences were observed between SLT placement and non-placement sites: higher gingival inflammation (GI) at placement sites (1.54±0.61 vs. 1.45±0.54, p=0.01), lower GBI at placement sites (40.0% vs. 84.3%, p=0.001), and more prevalent GR (65.7% vs. 34.3%, p=0.03) at placement sites. Probing depths ≥ 3 mm were also less frequent at placement sites (2.67±0.72) than non-placement sites (3.37±1.03, p=0.001). These results highlight the detrimental impact of SLT on periodontal health, emphasizing the need for targeted interventions among SLT users. SLT use is associated with adverse effects on oral health, including GI, plaque accumulation, gingival bleeding, GR, and changes in the oral mucosa. Targeted interventions and public health policies are needed to address these issues effectively.

A Study On Insight Into Cessation Attempts Among Current Smokeless Tobacco Users In An Urban Slum Of Ahmedabad

Introduction:According to GATS-2 report, one out of every five persons in Gujarat uses smokelesstobacco (SLT).Tobacco causes addiction & dependence over a period of time.Tobacco cessation is anintegral part of the National Tobacco Control Programme.Objective:To estimate the proportion ofprevious quit attempts and its determinants among current SLT users of an urban slum inAhmedabad.Methods:A community-based, cross-sectional study using consecutive sampling wasconducted between June 2023 - August 2023 among 250 current SLT users in an urban slum ofAhmedabad( Ward number 15). A pre-tested, semi-structured questionnaire adapted from GATS-2(Global Adult Tobacco Survey-2) Tobacco Questions for Surveys was administered among theparticipants for eliciting sociodemographic characteristics, SLT consumption pattern and quittingattempts. Results:In this study, 68.8% of the participants had at least one past quit attempt out ofwhich 94.7% tried self- control methods. The most common reason for not being able to quit wasperceived as addiction (70.9%). A larger part of SLT users (89%) had noticed warning labels intobacco packets and 18.3% of them reported that they thought of quitting seeing that warning. Threefourth of the participants were advised by at least one person to not consume tobacco products & in60% of the cases, it was the spouse.Conclusions and recommendations:The results suggest that there is an obvious lacuna in the community's utilization of services, despite the fact that National Tobacco Control Programme (NTCP) provides nationwide cessation services. This demonstrates theneed for extensive community-based tobacco cessation activities. Keywords:Smokelesstobacco(SLT), Addiction,Quit Attempt, National Tobacco Control Programme(NTCP)

IJCM_191A: A study of awareness regarding harmful effects of tobacco consumption among an urban population of Raipur.

Background: Tobacco consumption has been significantly linked to increased mortality and morbidity. It gives rise to several diseases such as lung cancer, oral cancer, COPD, asthma, and dental problems as well as aggravates other diseases like TB, asbestosis, heart ailments, etc. It is the need of the hour to increase awareness about the adverse effects of tobacco addiction. Objectives: To study awareness regarding harmful effects of tobacco consumption among an urban population of Raipur. Methodology: Data was collected as part of an ongoing cross-sectional study in June 2023 in the Urban Field Practice area of AIIMS Raipur (Ward 24 and 25). Demographic details including age [40-74 years], gender, education, family type, addiction history, etc. were collected. A semi-structured questionnaire adapted from the WHO STEPS survey and GATS survey was used to collect information on tobacco awareness. Results: Data entry was done in Excel and analyzed in SPSS version 21. Among the 200 participants, 54.5% (109) were female and the rest male. The majority of participants belonged to Hindu religion (96.5%), nuclear family type (50%), and OBC caste (54%). About 10.5% of participants were current smokers, most of them male. Smokeless tobacco consumption like gudakhu, gutkha, and pan was more prevalent than smoking, especially in women (29%). Smokeless tobacco consumption was almost equal in both genders. Awareness improved with an increase in educational status and with younger age categories, which were found to be significant. Only 73% of males and 39.4% of females were aware of the harmful health effects of tobacco consumption. Conclusion: Illiteracy and easy accessibility of tobacco products at cheap prices, especially for smokeless tobacco and lack of awareness has led to extensive consumption of these products and hence, efforts must be made in these directions by various measures, such as policies, bans, taxes and health education.

The Human Papillomavirus Enigma: A Narrative Review of Global Variations in Oropharyngeal Cancer Epidemiology and Prognosis.

Oropharyngeal cancers (OPCs) in Asia account for 42% of the global burden and over 50% of related deaths. Human papillomavirus (HPV) is involved in over 70% of OPC cases in the Western hemisphere, but its role in the Eastern hemisphere is unclear. This study reviews OPC epidemiology, including prevalence, etiological factors (such as smokeless tobacco and HPV), and their interaction. Among the SEAR countries, India had the highest incidence of HPV-related OPCs at 38.4%, while data were unavailable for most African countries, with only a 14% incidence reported. Conversely, the American region exhibited one of the highest HPV positivity rates, reaching up to 65% in different states of the USA, while Brazil reported an incidence of up to 38%. In the European Union, the UK had the highest incidence of HPV-associated OPC, reaching up to 52%. In the Western Pacific region, New Zealand demonstrated the highest incidence at up to 78%. Smokeless tobacco consumption was higher in SEAR countries, which had a relatively lower incidence of HPV infection, suggesting a negative correlation between the two. Based on our literature search, the most common detection methods used globally are immunohistochemistry for p16 and polymerized chain reaction. OPCs are a global health concern, and proper identification and classification are vital. HPV-driven cancers have better survival rates, emphasizing the need for focused research on specific problem areas based on the burden of HPV-positive or HPV-negative cancers.

The Prevalence of Smokeless Tobacco Consumption and Its Effects on Gingival and Periodontal Health Among the Adults in the Emirates of Sharjah, UAE – A Cross-Sectional Study

ABSTRACT Introduction: Smokeless tobacco (SLT) has been linked with various oral signs and symptoms, such as oral mucosal lesions and gingival and periodontal effects. However, there is limited research on the prevalence of SLT use and its impact on gingival and periodontal health in the adult population of the Emirates of Sharjah. Aim: To assess the prevalence of SLT consumption and its effects on gingival and periodontal health in the adult population of the Emirates of Sharjah. Methods: The study evaluated 171 dentate patients aged 18–77 years who use SLT or are nonsmokers. Data were collected through a questionnaire on SLT use and periodontal health assessed using plaque index, gingival index (GI), attachment score, and gingival recession (GR). Statistical analysis was done using SPSS 27.0 version. Results: Among 390 screened participants, 28 subjects (21 males and 7 females) were SLT users with prevalence of 7.18%. No significant differences were found in plaque index, GI, or periodontal pocket depth. However, SLT users had significantly higher clinical attachment loss scores (mean 4.01 mm, SD 0.35) compared to non-users (mean 1.49 mm, SD 1.12). Significant differences were also observed in GR. Conclusions: This study provides insights into the prevalence and impact of SLT use on periodontal and gingival health in UAE adults. SLT usage is associated with a higher risk of periodontitis and gingivitis, indicating the need for awareness and intervention. Further research is required to validate results and consider confounding factors.

Factors Influencing the Consumption of Tobacco amongst the Khasi Indigenous People in Northeast India.

Tobacco use in any form is a major public health concern. It accounts for nearly 1.35 million deaths every year. Many chronic illnesses occur due to the consumption of tobacco, either smoke or smokeless form. The study aims to explore how smoking and smokeless tobacco consumption are distributed across a range of demographic and socioeconomic markers among Khasi indigenous people in Northeast India. It is a case-control study conducted in adults over 31 years of age. The study was carried out between June 2020 and August 2021. An Independent t-test was performed to determine the significant difference in age between smoking/smokeless tobacco users and non-tobacco users. Univariate and Multivariate analyses were conducted to determine the significant predictors affecting the use of smoking/smokeless tobacco in the respondents. A total of 505 respondents were included in the present study. There was a high statistically significant difference in the income level of tobacco and non-tobacco users (P value- 0.002). In Univariate analysis, it was found that the odds of consuming both forms of tobacco were significantly lower in the respondents aged between 51-60 (OR = 0.61, P value = 0.0453). The participants who studied till graduation and above had lower odds of both using forms of tobacco as compared to respondents who were illiterate/primary educated only (OR = 0.85, P value = 0.046). In conclusion, smoking and smokeless tobacco consumption are still widely prevalent in this region and strongly associated with age, gender, level of education, and place of residence. There is a need for further detailed analysis to identify risk factors that are strongly associated with the use of smoke and smokeless tobacco so that the community will be conscious about the hazardous effects of tobacco use in any form.

Socioeconomic inequality among smoking and smokeless tobacco uses among males in India: a decomposition analysis

ObjectiveIndia is the third-largest tobacco manufacturer and its use in India is characterised by a high prevalence of smoking and smokeless (sl) tobacco use. This results in 1 million deaths per year in the country. Given the high burden of tobacco use, this study examines the regional variations and socio-economic correlates of tobacco use in India. MethodsNational Family Health Survey- 5 (2019–2020) have been analysed for the purpose of the study. A sample of 101,839 males aged 15–54 years was included in this study. Primary outcomes of tobacco use were categorised into smoking, smokeless and dual use of smoking and smokeless tobacco use. Bivariate analysis and decomposition analysis was done to study the socio-economic inequality. ResultsThe prevalence of tobacco use among males in India is around 41 percent. As indicated by the results of the logistics regression, age is positively related to smoking among males. Males aged 45–54 years are 2.5 (95 % concentration index [CI]:2.30–2.63) times probable to smoke, 1.4 (95% CI: 1.30–1.47) times probable of smokeless tobacco consumption and 2.2 (95% CI: 2.10–2.35) times more prone to using both types of substances compared to the younger age group. Males who are widower use smokeless 1.69 times (95% CI: 1.44–1.99) higher with reference to unmarried males. Males belonging to Scheduled tribes are 1.2 (95% CI: 1.13–1.25) times more likely to smoke, 1.3 (95% CI: 1.24–1.37) times more likely to use smokeless substances and 1.4 (95% CI: 1.33–1.47) times more likely to have dual use of tobacco than other social groups. Manual workers (both skilled are unskilled) are likely to smoke (odds ratio [OR] = 1.1, 95% CI: 1.02–1.11), use smokeless tobacco (OR = 1.3, 95% CI: 1.23–1.34) and have dual use of tobacco (OR = 1.29, 95% CI: 1.24–1.34) more than that of other categories. The decomposition of the concentration index shows a significant contribution from factors like a no education, ST/SC caste and wealth index. Among the states and union territories, the prevalence of tobacco is high in West Bengal, Tripura, Mizoram, Manipur, Meghalaya and Sikkim. ConclusionThis study is useful for informing target-based prevention policies since it helps in highlighting regions, socio-economic and demographic groups especially vulnerable to tobacco addiction. In India, males from poorer and vulnerable socio-economic backgrounds are more likely to use tobacco. State wise, the eastern zone starting from West Bengal to the North-Eastern states have higher tobacco use than the rest of the country. There is an urgent need to frame policies for controlling the use of tobacco especially among high-risk groups.

Effect of Tobacco Use during Pregnancy on Fetal Birth Weight Born to Women between 18-35 years in Thatta District

Background: Consumption of tobacco in its various forms is widespread and a serious public health issue globally. Although smoking is the predominant common method of tobacco use, the consumption of smokeless tobacco has increased in recent decades. Smokeless tobacco products are becoming more popular among women. In Pakistan, the overall prevalence of smokeless tobacco among males and females is 7%, out of which 10% are women which may be linked to poor reproductive outcomes and other health issues. Objective: The purpose of the study was to determine the effect of smokeless tobacco use during pregnancy on fetal birth weight. Methods: A case-control study was conducted at the five basic health units (BHU) of Thatta District, which were Garho, Ghora Bari, Dhabeji, Chattochand, and Jhimpeer from October 2022 – January 2023. A total of 300 mothers were included by consecutive sampling technique in the study and among them, 150 mothers who gave birth to a low-birth-weight baby i.e., birth weight < 2.5 kg were enrolled as a case, and another 150 mothers who gave birth to a normal birth weight baby i.e., birth weight ≥ 2.5 kg were enrolled as a control. Data collection involved face-to-face interviews utilizing a validated questionnaire, with strict adherence to ethical considerations throughout the study. Results: In a study of 300 participants from Thatta District's five basic healthcare units, multivariate logistic regression revealed significant factors influencing tobacco use during pregnancy. Housewives had 1.862 times higher odds of tobacco use than employed individuals, and individuals aged 20–35 had 1.802 times higher odds than those aged 36-50. Smokeless tobacco, particularly most of the mothers in this study used gutka (47.3%) and chaliya (26%). Smokeless tobacco Gutka and Chaliya, increased the likelihood of tobacco use during pregnancy. Considering the frequency of smokeless tobacco use and healthcare provider recommendations emerged as important determinants. Conclusion: Our study underscores the prevalence of smokeless tobacco use during pregnancy in Thatta, Karachi, Pakistan, with significant implications for low-birth-weight babies. This highlights the need for targeted public health interventions, like antenatal care, alongside further research to inform evidence-based strategies for maternal and child health promotion in the region.

Prevention of Initiation of Smokeless Tobacco and Non Tobacco Products Consumption Among Students of a Private High School in Puducherry: An Interventional Study

Prevention of Initiation of Smokeless Tobacco and Non Tobacco Products Consumption Among Students of a Private High School in Puducherry: An Interventional Study

How do family members influence smokeless tobacco consumption during pregnancy in India? Perspectives of pregnant women.

Smokeless tobacco (ST) use in South Asia is culturally ingrained and socially accepted. A better understanding of these sociocultural influences could inform behavioural approaches to prevent ST use. We sought to understand how family members influence pregnant women's behaviour, attitudes, and perceptions towards ST use. Moreover, we captured the influence of community health workers in this context. A qualitative study using a framework analysis was conducted in selected Indian populations. Eight in-depth interviews among pregnant and postpartum women were conducted in Gujarati, the local language, investigating ST use during pregnancy and the influence of family and peers. All transcripts were transcribed verbatim and translated into English and analyzed in NVivo. The social norms and expectations around ST during pregnancy appeared to have shifted away from promoting towards discouraging its use in the past few years. Women described how their spouses and other family members encouraged them to stop using ST during pregnancy, with some women must hide their ST use from their family members. They also received advice on the harms of ST use from community health workers (Accredited Social Health Activist-ASHA workers). Influenced by the advice received from such workers, several women tried to reduce their ST use during pregnancy. Our findings suggest that the acceptability of ST use in pregnancy may be in decline among families in India. Hence, efforts to promote ST prevention during pregnancy are likely to be "pushing against an open door". Furthermore, community health workers appeared to play an influential role in supporting women to abstain from ST use during pregnancy.

Tobacco consumption in Mozambique in 2005 and 2015.

The burden related to smoking exposure is growing in many low-income settings. We aimed to quantify the use of smoked and smokeless tobacco in Mozambique in 2014/2015, and to compare the estimates with those obtained in 2005. A cross sectional study was conducted in 2014/2015 on a representative sample of the Mozambican population aged 15 to 64 years, following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS). Prevalence estimates with 95% confidence intervals were computed for different categories of tobacco consumption. The age-standardised prevalence in the age-group 25-64 years was compared with results from a STEPS survey conducted in 2005. Between 2005 and 2014/2015, the prevalence of daily smoking decreased from 9.1% to 3.4% (p < 0.05) in women and from 33.6% to 27.3% (p < 0.05) in men. There was a significant decrease in the daily consumption of hand-rolled cigarettes among women (from 3.1% to 1.4%, p < 0.05). Among men, there was a decrease in the prevalence of daily consumption of smokeless tobacco (from 3.5% to 1.0%, p < 0.05). In 2014/2015, both manufactured and hand-rolled cigarette consumption were more prevalent among men, while the use of smokeless tobacco was more common among women; the consumption of both hand-rolled cigarettes and smokeless tobacco were more prevalent in rural settings. In Mozambique, there was a decrease in the prevalence of daily smokers in both genders and of daily consumption of smokeless tobacco among men between 2005 and 2014/2015. Efforts are needed to maintain the positive trends.

Awareness of Oral Cancer Among Users of Smokeless Tobacco: A Cross-Sectional Study.

Smokeless tobacco (SLT) stands out for its higher nicotine absorption and its role in preventable fatalities. The Global Adult Tobacco survey in Saudi Arabia revealed SLT usage, while past legislation restricted its use. Linking SLT consumption to oral cancer and oral mucosal ulcers, the study addresses its prevalence in head and neck malignancies. This study is cross-sectional and includes adult users of SLT. Raosoft (Raosoft Inc., Seattle, WA) was used to calculate the sample size. The data was analyzed using SPSS software (IBM Corp., Armonk, NY). The research study investigated various sociodemographic characteristics and prevalence of SLTuse among participants. All participants reported using SLT, with toombak (33.2%) and shamma(36.0%) being the most prevalent. Notably, reasons for initiating SLT included influence from peer pressure (33.6%), alternatives to smoking (32.0%), and influence from relatives (19.0%). While 75.1% intended to quit within a year, awareness of SLT's harmfulness varied: 40.3% believed it was less harmful than smoking, and 57.7% recognized its link to oral cancer. Additionally, 62.2% believed SLT could lead to dependence. Sociodemographic factors generally did not significantly affect awareness of SLT causing oral cancer. The findings indicate a significant prevalence of SLT use, with toombak and shammabeing the most common types consumed. Awareness of the potential harm of SLT use in relation to oral cancer varied among participants, with a notable proportion misunderstanding its harmfulness compared to smoking tobacco.

Comparative Analysis of Dentition and Periodontal Status in Patients With Unilateral Smokeless Tobacco Pouch Keratosis.

The consumption of smokeless tobacco (SLT) and related products has become an epidemic worldwide, especially among young people, as they come into direct contact with the tissues of the oral cavity. Therefore, the present cross-sectional study was conducted to compare the status of dentition and periodontal health of teeth associated with the unilateral SLT pouch keratosis with the unaffected contralateral side. In this study, 96 SLT users from north Maharashtra, India, with unilateral SLT pouch keratosis were studied. Demographic data, past and present SLT use history, features of SLT pouch keratosis, modified community periodontal index, dentition status index, and loss of tooth attachment were recorded. Data were collected and subjected to statistical analysis using the unpaired t-test and chi-square test. The results of the present study showed a significant difference (p≤0.05) in gingival bleeding, pocket depth, and attachment loss in teeth associated with smokeless tobacco keratosis (STK) compared to teeth at the contralateral sides of the arch. The duration of tobacco use had a significant effect on the severity of loss of attachment at SLT pouch keratosis sides. There was a significant difference (p≤0.05) in the mean scores of the sound crown, carious crown, and coronal caries status between the SLT pouch keratosis side and the contralateral side. The results of the study revealed that significant gingival bleeding, gingival recession, and attachment loss in the teeth are associated with SLT pouch keratosis compared with the teeth on the contralateral side without the lesion.

Characterization of physiochemical parameters & their effect on microbial content of smokeless tobacco products marketed in north India.

Smokeless tobacco (SLT) product consumption has profound public health implications for its users. The p H and moisture of SLTs determine the bioavailability of nicotine, the microbial structure dynamics and the amount of microbial conversion of tobacco alkaloids to carcinogenic tobacco-specific nitrosamines. This study aimed to characterize and compare the p H, moisture and alkaloid content of various SLT products. Thirty-seven SLT samples including khaini , snus, moist snuff, gul , pan masala , zarda , Mainpuri kapoori and qiwam were collected from the retail market around the National Capital Region in north India and their p H, moisture, nicotine and alkaloid content were measured. The p H and total nicotine were used to calculate the amount of free nicotine, the readily absorbed form, for each product by applying the Henderson-Hasselbalch equation. The investigation showed that the SLTs varied drastically in their p H (5.36 to 10.27), moisture content (4.7 to 51.7%) and alkaloid content (0.82 to 35.87 mg/g). The p H and free nicotine levels of a product were found to be positively correlated, and the highest free nicotine content was reported in snus samples. Further, the moisture content was seen to impact the bacterial and fungal diversity in these samples. Studies to detect the presence of pathogenic microbiological genera as well as potentially toxic constituents are warranted. The use of SLTs as an alternative to cigarette smoking should be discouraged, and cessation programmes must call attention to their detrimental effects and emphasize on benefits of quitting SLT consumption.

Smokeless tobacco consumption and its association with risk factors of chronic kidney disease in rural and peri-urban Bangladesh.

Compared to smoking, which has major consequences in chronic kidney disease (CKD) initiation and progression, smokeless tobacco (SLT) consumption is considered to have fewer health consequences. We investigated the prevalence of SLT consumption and its association with risk factors of CKD in a rural and peri-urban Bangladeshi population. Using random sampling we recruited 872 adults in 2020, from the Mirzapur Demographic Surveillance System of Bangladesh, who had resided in the area for at least five years. Interviews using a semi-structured questionnaire, physical examination and anthropometric measurements were done, followed by blood and urine testing. The blood and urine tests were repeated in selected participants after three months as per the CKD Epidemiology Collaboration equation. The prevalence of SLT consumption was 29%. Being aged ≥46 years (OR=7.10; 95% CI: 4.79-10.94), female (OR=1.64; 95% CI: 1.21-2.22), housewife (OR=1.82; 95% CI: 1.35-2.45), farmer (OR=1.71; 95% CI: 1.06-2.76), widow (OR=3.40; 95% CI: 2.24-5.17), and having no formal schooling (OR=4.91; 95% CI: 3.59-6.72), family income of <$100/month (OR=1.66; 95% CI: 1.13-2.43), sleeping duration <7 hours per day (OR=2.33; 95% CI: 1.70-3.19), were associated with a significantly higher odds of SLT consumption. However, being aged 31-45 years (OR=0.25; 95% CI: 0.16-0.38) had significantly lower odds of being an SLT consumer. Among the diseases investigated, undernutrition (OR=1.63; 95% CI: 1.15-2.33), hypertension (OR=1.52; 95% CI: 1.13-2.05), anemia (OR=1.94; 95% CI: 1.39-2.71) and CKD (OR=1.62; 95% CI: 1.15-2.27) were significantly associated with SLT consumption. In the multivariable analysis, being aged 31-45 years (AOR=3.06; 95% CI: 1.91-4.90), ≥46 years (AOR=15.69; 95% CI: 4.64-53.09) and having no formal schooling (AOR=2.47; 95% CI: 1.72-3.55) were found to have a significant association with being an SLT consumer. SLT consumption is associated with most of the established risk factors of CKD within the studied population.

A model to explain smokeless tobacco consumption in adults: A grounded theory study

IntroductionSmokeless tobacco use remains a significant public health concern, necessitating the acquisition of comprehensive and extensive data to effectively address and control its consumption. Understanding the underlying patterns of consumption is crucial for this purpose. ObjectiveThis study aimed to develop a model that explains smokeless tobacco consumption among adults in the southeastern province of Iran, specifically in the city of Chabahar. MethodsA qualitative study was conducted using a grounded theory approach with inductive processes. The participants consisted of 30 adults aged 18–64 years from Chabahar City in southeastern Iran. Purposive sampling was used to select participants, and data collection continued until theoretical saturation was achieved. Data analysis followed Strauss and Corbin's perspective, involving four stages: Analyzing Data for Concepts, Analyzing Data for Context, Bringing Process into the Analysis, and Integrating Categories. ResultsThe analysis of data yielded three main categories: “starting to use,” “continued use,” and “cessation attempts,” each with their respective subcategories. Additionally, two main categories related to the consequences of smokeless tobacco consumption were identified: “addiction and efforts to overcome addiction,” also with their respective subcategories. ConclusionThe Dependency Cycle Model in Consumption provides a comprehensive understanding of the contextual factors, processes, and consequences associated with smokeless tobacco consumption. This model serves as a valuable tool for researchers aiming to develop effective interventions in the field of smokeless tobacco consumption.

Prevalence of tobacco consumption among the Northeast population of India

Background and Objectives: Widespread use of tobacco among Indians has been associated with several lung diseases; however, the exact prevalence of tobacco use, particularly in the northeastern region of India, is not known. Therefore, we conducted a systematic review and meta-analysis to evaluate the prevalence of tobacco use among the northeast population of India. Methodology: Four electronic databases were searched using the appropriate search strategy. A systematic search yielded 15 articles that were included in this review. Out of these, 13 studies were found to be eligible for meta-analysis. Risk of bias was assessed using the Hoy et al. scale. Statistical analysis was done using the STATA version 16. Results: Data from 453,844 participants, mean age range of 15–60 years, were collected from the northeastern states. The overall pooled prevalence estimate for the tobacco consumption reported was found to be 44.71% (95% confidence interval [CI]: 16.48%–72.93%). Manipur reported comparatively higher tobacco consumption than the other eastern northeastern states 45.13% (95% CI: 7.26%–72.93%). A higher pooled prevalence was found for the employed (31.10%; 95% CI: 24.83%–83.00%) versus unemployed (26.96%; 95% CI: 22.07%–31.86%), and literates (40.36%; 95% CI: 16.19%–64.54%) versus illiterates (19.87%; 95% CI: 3.95%–35.79%). In addition, smokeless tobacco (29.10%; 95% CI: 9.33%–48.88%) consumption was reportedly higher than that of smoked tobacco (22.96%; 95% CI: 1.74%–44.18%). Gender subgroup analysis showed a higher prevalence in males (28.59%; 95% CI: 24.16%–33.02%) as compared to females (25.77%; 95% CI: 17.68%–33.86%). Conclusion: A higher prevalence of tobacco use among the northeastern region of India, particularly males, the employed class, and illiterate people, suggests a dire need of more effective awareness programs to reduce tobacco consumption.