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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 10  |  Issue : 2  |  Page : 31-33

A study to assess the prevalence, knowledge, and sociodemographic predictors of tobacco use among adults in Gujarat


Clinical Practitioner, Daman, Daman and Diu, India

Date of Submission25-May-2022
Date of Acceptance03-Jun-2022
Date of Web Publication29-Jun-2022

Correspondence Address:
Dr. Nilima Vaghela
Clinical Practitioner, Daman, Daman and Diu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/INJO.INJO_13_22

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  Abstract 

Background: Tobacco Consumption is a public health challenge In India. The purpose of this study was to examine occupation-, education-, and gender-specific patterns of tobacco use and knowledge of its health effects among 1000 rural Asian Indians ≥18 years in Gujarat. Materials and Methods: A statewide, community-based, cross-sectional survey was conducted in Gujarat, using face-to-face interviews. Results: Tobacco consumption was significantly higher among males, those who were self-employed, and those with elementary education. The prevalence was higher among males than females. Adjusted ORs for tobacco use showed a strong gradient by age and educational level. Conclusion: Effective educational programs should be tailored by gender to improve knowledge of health risks and dispel myths about the perceived benefits of tobacco.

Keywords: Adults, knowledge, prevalence, sociodemographic predictors, tobacco use


How to cite this article:
Vaghela N. A study to assess the prevalence, knowledge, and sociodemographic predictors of tobacco use among adults in Gujarat. Int J Oral Care Res 2022;10:31-3

How to cite this URL:
Vaghela N. A study to assess the prevalence, knowledge, and sociodemographic predictors of tobacco use among adults in Gujarat. Int J Oral Care Res [serial online] 2022 [cited 2022 Aug 16];10:31-3. Available from: https://www.ijocr.org/text.asp?2022/10/2/31/348772




  Introduction Top


Despite great achievements in public health globally, problems with tobacco consumption exist in both developing and developed nations. Tobacco consumption is responsible for 50%of all the cancers in men and 25% in women.[1],[2],[3],[4] In India, tobacco is consumed in several forms, which include smoking as well as smokeless tobacco. Habitual chewing of betel squid or use of tobacco in smoking or smokeless forms by men and women in India is due to less awareness of its health hazards or because of prevalent sociocultural perceptions.[5],[6],[7] In addition, social norms, availability, acceptability, and advertising campaigns also influence tobacco use, particularly among males.[8] Hence, gender disparities in tobacco use are noted with a significantly higher proportion of males and low-income people consuming tobacco in one or several forms.[9] Previous studies show that tobacco consumption is higher among the less educated, older age groups (especially middle-aged males), and agricultural and labor workers.[6],[7],[8],[9],[10],[11],[12]. Although statewide, population-based research on the role of poor health, rurality, and socioeconomic factors in disparities in tobacco consumption is limited, the GATS survey showed that in the state of Gujarat 20.1%–30% of the population use tobacco.[6] There is a dearth of studies that have examined the prevalence and sociodemographic predictors of tobacco use in rural regions of Gujarat. Hence, the purpose of this study was to (1) determine the prevalence of tobacco use by gender; (2) assess their knowledge of harmful health effects; and (3) examine sociodemographic predictors of tobacco use (overall, smoking, and chewing/smokeless form).


  Materials and Methods Top


This was a cross-sectional study conducted in Gujarat. The tobacco use question came from the Behavioral Risk Factor Surveillance System (Centers for Disease Control and Prevention, United States),[13] and the questions on various forms were added as a checklist with frequency of use and types. Items on the type and the frequency of tobacco use are provided in Tobacco Use and Knowledge. A total of 1000 participants completed the survey questionnaire (response rate ~94%). All procedures performed in the study were conducted in accordance with the ethics standards given in 1964 Declaration of Helsinki, as revised in 2013. The study proposal was submitted for approval and clearance was obtained from the ethical committee of our institution. A written informed consent was obtained from each participant. The sample was large enough to provide reliable estimates of prevalence of tobacco consumption by sex and socioeconomic population groups. Participants are comprised of adults over 18 years of age and residing in rural regions of the state. Individuals younger than 18 years and adults whose medical conditions did not allow accurate assessments were excluded from the study. Data collection occurred between December 2020 and May 2021. Participants’ demographic information included age, gender, educational status, and income level. Age was collected categorically in years. Tobacco Use and Knowledge was collected with the help of a questionnaire. Each correct response to these questions was given a value of “1” and the incorrect response a value of “0.” The knowledge score was calculated by summing the correct responses to the two cancer awareness questions (range 0–2). Cronbach α for the knowledge score was 0.75, indicating good reliability. Completed data collection forms were deidentified and data were coded and entered into an SPSS database (SPSS Inc., Chicago, Illinois). Descriptive statistics included gender, age, income, educational level, and tobacco use. Point estimates of the prevalence of tobacco consumption were calculated. Analysis was also conducted to detect the differences in health hazards of tobacco consumption knowledge by age, occupation, and educational level; distribution of tobacco consumption by demographic characteristics was analyzed using Chi-square.


  Results Top


The mean age of the sample was 35 years. The majority or approximately 20% of the participants were between 18 and 34 years of age followed by 35–44 years’ (57%) age group and 23% who were 45 years old and older. The sample was almost evenly distributed by gender, that is, males (68%) and females (32%). Information on the occupational status of participants showed that 43% were self-employed (as farmers or small business owners) and approximately half reported that they were unemployed. In addition, the majority of females were homemakers and only a few (0.6%) were employed for wages. Rural Indians tend to have higher levels of illiteracy and our study reflected that 10% had no formal education, 40% reported elementary level education, 15% had some high school education or were high school graduates, and 35% had a college degree. The overall prevalence of tobacco use (in all forms) was 25%; among all participants. Among tobacco users, 65% smoked bidis and cigarettes, whereas 35% chewed or used smokeless forms of tobacco such as paan masala, paan, gutka, toothpaste, and other commercially available tobacco products. A higher frequency of tobacco consumption, that is, between 8 and 10 times a day, and in various forms, was reported by several participants in our study. Approximately 5% of male and female respondents in rural Gujarat used tobacco in both forms of smoking and chewing/smokeless tobacco. The knowledge of health hazards associated with tobacco consumption was compared for males and females across age, occupation, educational level, and type of tobacco use [Figure 1]. Overall, rural females had significantly higher knowledge of the health consequences associated with tobacco use than rural females (P < .001). In addition, younger individuals between the ages of 18–34 years had significantly higher knowledge than individuals over 35 years of age (F statistic = 46.2; P < .001). Comparison of tobacco knowledge by occupational status showed that self-employed individuals had significantly higher knowledge (1.75 = 0.53) than those who reported that they were unemployed or employed for wages (F statistic = 46.2; P < .001). Participants with formal education had higher knowledge (1.73 = 0.52; 1.71 = 0.55, resp.) than those with no formal education.
Figure 1: Knowledge regarding health risks of tobacco use

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  Discussion Top


Tobacco consumption is a public health challenge in India. Tobacco products such as bidis, gutka, and paan masala are locally manufactured, inexpensive, and easily available in rural India. Crude forms of tobacco are easily available and accessible, are relatively cheaper, and are used by socioeconomically disadvantaged people. However, they have more harmful health effects.[9],[10] For example, bidis have higher concentrations of tar and carbon monoxide and crude smokeless forms are highly carcinogenic contributing to increasing rates of oral cancers in India. The socioeconomic burden of tobacco and related diseases is significantly higher than the contribution by the tobacco industry to government revenues.[11] Yet, aggressive marketing by transnational tobacco companies has expanded their markets and increased rates of consumption.[12] Furthermore, cultural acceptability and perceptions of safe and beneficial effects have resulted in greater use of smokeless and chewing tobacco. Smokeless tobacco was preferred among men and bidis and cigarettes were preferred among younger men. Our results are also comparable to the findings of previous local and national studies that show that males and agricultural/labor class workers used tobacco more frequently in India compared to females.[6],[9],[11] A higher use of tobacco among older adults may also predispose them to chronic diseases, as it has been shown that tobacco is a modifiable risk for noncommunicable diseases for heart disease and type 2 diabetes and its complications; these chronic conditions are high among Indians, which is the leading cause of death and disability and direct and indirect health care costs.[12],[13],[14],[15] The higher rates of tobacco use among the older age groups may be due to its addictive nature after initiation and cultural acceptance of its use over time. Hence, efforts to educate and reduce tobacco consumption. The present study provided statewide prevalence of tobacco consumption in remote rural areas of the state. Future research should compare rural with urban and semiurban areas and also test the impact of interventions and educational campaigns.


  Conclusion Top


The results from this study indicate a gender disparity in tobacco prevalence with higher usage among males, especially self-employed and low educated individuals in rural Gujarat. Effective education programs that are gender-specific and community-based that focus on improving awareness and knowledge of associated health risks among users using a grounds-up model by utilizing community health workers, public health, dental public health professionals, and dentists are suggested. In addition, debunking myths on perceived benefits of tobacco use as well as regulatory enforcement of warning labels on all tobacco products can reduce tobacco use and its related health and economic burden.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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2.
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Gupta PC, Mehta HC Cohort study of all-cause mortality among tobacco users in Mumbai, India. Bull World Health Organ 2000;78:877-83.  Back to cited text no. 9
    
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Gupta PC, Bhonsle RB, Mehta FS, Pindborg JJ Mortality experience in relation to tobacco chewing and smoking habits from a 10-year follow-up study in Ernakulam district, Kerala. Int J Epidemiol 1984;13:184-7.  Back to cited text no. 10
    
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Balaram P, Sridhar H, Rajkumar T . Oral cancer in Southern India: The influence of smoking, drinking, paan chewing and oral hygiene. Int J Cancer 2002;98:440-5.  Back to cited text no. 11
    
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Dikshit RP, Kanhere S Tobacco habits and risk of lung, oropharyngeal and oral cavity cancer: A population-based case-control study in Bhopal, India. Int J Epidemiol 2000;29:609-14.  Back to cited text no. 12
    
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Kumar D, Raithatha SJ, Gupta S, Raj R, Kharod N Burden of self-reported noncommunicable diseases in 26 villages of Anand District of Gujarat, India. Int J Chronic Diseases 2015;2015:6.  Back to cited text no. 13
    
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Sansone GC, Raute LJ, Fong GT, Pednekar MS, Quah AC, Bansal-Travers M, et al. Knowledge of health effects and intentions to quit among smokers in India: Findings from the tobacco control policy (TCP) India pilot survey. Int J Environ Res Public Health 2012;9:564-78.  Back to cited text no. 14
    
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Jhanjee S, Lal R, Mishra A, Yadav D Tobacco use and dental myths in India: need for specific intervention. Gerodontology 2016;33:573-4.  Back to cited text no. 15
    


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