Current Pattern of Product Specific Smokeless Tobacco Use in Bangladesh

Background: Tobacco use is one of the foremost causes of preventable morbidity and mortality. The objective of the study was to identify the pattern of smokeless tobacco use and to estimate the prevalence and to identify Sociodemographic correlates of smokeless tobacco consumption. Data and methods: We used the data from the 2010 Global Adult Tobacco Survey (GATS) in Bangladesh. The data were representative for men and women aged 15 years and above. The survey was based on a three-stage stratified cluster sample of household. Information of a total of 9629 adults, aged 15 years and over, was analyzed by stratified them into urban (4857) and rural (4772) groups. Stata Version 11.0 and Excel were used to analyze the dataset. Predictors of prevalence for smokeless tobacco use were analyzed using selected socioeconomic and demographic characteristics that include residence, age, gender, education, occupation and wealth index. Associations between smokeless tobacco consumption and the explanatory variables were estimated using simple and multiple logistic regression model. Results: Current smokeless tobacco users daily were significantly higher (p=0.001) in urban females (21.92%) in comparison to urban males (18.13%) and also significantly higher (p<0.001) in rural females (30.60%) in comparison to rural males (25.92%). In the multivariate analysis the adjusted OR were significantly higher in rural area (OR=1.15, 95% CI=1.02-1.29) in comparison to urban area. Similarly adjusted OR were significantly higher in females (OR=1.68, 95% CI=1.38-2.30) in comparison to males. The adjusted OR increased with age from 3.09 (95% CI=2.45-3.93) in the age group 25-34 to 12.70 (95% CI=10.02-16.11) among individuals with 46 years and above age group, in comparison to individuals in the age group less than or equal to 24 years. Education and smokeless tobacco use showed significant inverse relationship with significantly elevated OR in the low education group (no formal schooling, OR=4.28, 95% CI=2.48-7.38), less than primary school completed (OR=3.28, 95% CI=1.89-5.68) and primary school completed (OR=3.61, 95% CI=2.08-6.29) in comparison to high education group (post graduate degree). Conclusion: The prevalence of current smokeless tobacco consumption is high among rural women and among all smokeless tobacco products, the prevalence of the use of betel quid with tobacco was the highest in Bangladesh. Awareness should be given priority to decrease the growing smokeless tobacco consumption. Also tobacco control campaigns should target rural poor older women and monitor all forms of smokeless tobacco products used by the population.