Prevalence of Tobacco Use in Urban, Semi Urban and Rural Areas in and around Chennai City, India
India. PLoS ONE 8(10): e76005. doi:10.1371/journal.pone.0076005
Prevalence of Tobacco Use in Urban, Semi Urban and Rural Areas in and around Chennai City, India
Kolappan Chockalingam 0
Chandrasekaran Vedhachalam 0
Subramani Rangasamy 0
Gomathi Sekar 0
Srividya Adinarayanan 0
Soumya Swaminathan 0
Pradeep Aravindan Menon 0
Madhukar Pai, McGill University, Canada
0 National Institute for Research in Tuberculosis , Chennai , India
Background: Tobacco use leads to many health complications and is a risk factor for the occurrence of cardio vascular diseases, lung and oral cancers, chronic bronchitis etc. Almost 6 million people die from tobacco-related causes every year. This study was conducted to measure the prevalence of tobacco use in three different areas around Chennai city, south India. Methods: A survey of 7510 individuals aged . = 15 years was undertaken covering Chennai city (urban), Ambattur (semiurban) and Sriperumbudur (rural) taluk. Details on tobacco use were collected using a questionnaire adapted from both Global Youth Tobacco Survey and Global Adults Tobacco Survey. Results: The overall prevalence of tobacco use was significantly higher in the rural (23.7%) compared to semi-urban (20.9%) and urban (19.4%) areas (P value ,0.001) Tobacco smoking prevalence was 14.3%, 13.9% and 12.4% in rural, semi-urban and urban areas respectively. The corresponding values for smokeless tobacco use were 9.5%, 7.0% and 7.0% respectively. Logistic regression analysis showed that the odds of using tobacco (with smoke or smokeless forms) was significantly higher among males, older individuals, alcoholics, in rural areas and slum localities. Behavioural pattern analysis of current tobacco users led to three groups (1) those who were not reached by family or friends to advice on harmful effects (2) those who were well aware of harmful effects of tobacco and even want to quit and (3) those are exposed to second hand/passive smoking at home and outside. Conclusions: Tobacco use prevalence was significantly higher in rural areas, slum dwellers, males and older age groups in this region of south India. Women used mainly smokeless tobacco. Tobacco control programmes need to develop strategies to address the different subgroups among tobacco users. Public health facilities need to expand smoking cessation counseling services as well as provide pharmacotherapy where necessary.
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Competing Interests: The authors have declared that no competing interests exist.
Tobacco is used in forms either designed for smoking or for
non-smoking routes. Tobacco use alone is currently ranked fourth
in the world in its contribution to years of life lost [1]. The
smokeless forms of tobacco are used mostly in developing
countries, especially those in south East Asia. In India, tobacco
is smoked as a cigarette, beedi (a thin, Indian cigarette filled with
tobacco flake and wrapped in a tendu leaf tied with a string at one
end) cheroot (a cigar cut square at both ends), or in a pipe. The
smokeless forms of tobacco are chewed as raw tobacco leaves or
panmasala (a mixture of arecanut, tobacco and other ingredients),
or inhaled as snuff. Tobacco use is considered to be one of the
chief preventable causes of death in the world. Globally, smoking
causes about 71% of lung cancer, 42% of chronic respiratory
diseases and about 10% of cardiovascular disease. It is responsible
for 12% and 6% of male and female deaths respectively [2]. In
India, it was reported in 1990 that 1.5% of the total deaths were
tobacco related [3]. Tobacco continues to kill 6 million people
each year globally, including more than 600000 non-smokers who
die from exposure to tobacco smoke [4]. The chewing of tobacco
products is a risk factor for oral cancers [5]. Further, tobacco
consumption was found to be higher among the lower
socioeconomic groups [6].
Basic data on tobacco use at the national level is available from
the National Family Health Surveys [7] (a large scale, multi-round
survey conducted in a representative sample of households in
India). To estimate tobacco use among school children in the 8th
grade to 10th grade (ages 13 to 15 years) and adults (of age .15
years), nationwide Global Youth Tobacco Survey (GYTS) [8,9]
and Global Adult Tobacco Survey (GATS) have been conducted
[10]. However, there is limited data on the social and behavioural
factors that influence the use of various forms of tobacco and
attitudes of tobacco users towards quitting the habit.
Accordingly a study was planned and conducted in urban,
semiurban and rural populations residing in and around Chennai city
in the southern Indian state of Tamilnadu to estimate: a) the
prevalence of use of various forms of tobacco (cigarette/beedi
smoking, smokeless chewing tobacco or snuff) and study the factors
that influence use of tobacco. Behavioural patterns of tobacco use
among the adult population are described, based on their
knowledge, attitude and practice as captured in the questionnaire
adapted fr (...truncated)