Health knowledge and smokeless tobacco quit attempts and intentions among married women in rural Bangladesh: Cross-sectional survey.

INTRODUCTION AND AIMS The aim of this study was to investigate health knowledge, attitudes and smokeless tobacco quit attempts and intentions among married women in rural Bangladesh. DESIGN AND METHODS A cross-sectional survey was conducted using an interviewer administered, pretested, semistructured questionnaire. All 8082 women living in the Jhaudi and Ghotmajhee local government areas, aged ≥18 years with at least one pregnancy in their lifetime, were invited to participate. Questions covered smokeless tobacco consumption (STC), knowledge regarding its health effects, users' quit attempts and intentions and sociodemographic characteristics. RESULTS Eight thousand seventy-four women completed the survey (response rate 99.9%). Almost half (45%) of current consumers thought STC was good for their health and many ascribed medicinal values to it, for example 25% thought STC reduced stomach aches. A quarter had previously tried to quit and 10% intended to quit. After adjusting for potential confounders, inaccurate knowledge of STC health consequences was associated with being older [adjusted odds ratio (aOR) = 2.71, 95% confidence interval (CI) 1.99-3.50], less educated (aOR = 2.18, 95% CI 1.66-2.85), Muslim (aOR = 17.0, 95% CI 12.0-23.9) and unemployed (aOR = 29.7, 95% CI: 25.2-35.1). Having less education (aOR = 2.52, 95% CI 0.98-6.45) and being unemployed (aOR = 1.52, 95% CI 1.03-2.23) were associated with the intention to quit. DISCUSSION AND CONCLUSIONS Large gaps exist in rural Bangladeshi women's understanding of the adverse health effects of STC. Health awareness campaigns should highlight the consequences of STC. Routine screening and cessation advice should be provided in primary healthcare and smokeless tobacco control strategies should be implemented. [Hossain MS, Kypri K, Rahman B, Akter S, Milton AH. Health knowledge and smokeless tobacco quit attempts and intentions among married women in rural Bangladesh: Cross-sectional survey. Drug Alcohol Rev 2016;35:514-522].

[1]  Dhaval M Dave,et al.  Smokeless tobacco use in India: Role of prices and advertising. , 2015, Social science & medicine.

[2]  Md. Mahmudur Rahman,et al.  Why Do Bangladeshi People Use Smokeless Tobacco Products? , 2015, Asia-Pacific journal of public health.

[3]  R. Bahelah,et al.  Waterpipe tobacco labeling and packaging and World Health Organization Framework Convention on Tobacco Control (WHO FCTC): a call for action. , 2014, Addiction.

[4]  A. Milton,et al.  Prevalence and Correlates of Smokeless Tobacco Consumption among Married Women in Rural Bangladesh , 2014, PloS one.

[5]  A. Mukherjea,et al.  Culturally Specific Tobacco Use and South Asians in the United States , 2013, Health promotion practice.

[6]  R. Bhopal,et al.  A systematic review on the social context of smokeless tobacco use in the South Asian population: implications for public health. , 2012, Public health.

[7]  J. Pierce,et al.  What public health strategies are needed to reduce smoking initiation? , 2012, Tobacco Control.

[8]  M. Yunus,et al.  Sociodemographic Differentials of Selected Noncommunicable Diseases Risk Factors Among Adults in Matlab, Bangladesh: Findings From a WHO STEPS Survey , 2011, Asia-Pacific journal of public health.

[9]  M. Zaman,et al.  Smoking and smokeless tobacco consumption: possible risk factors for coronary heart disease among young patients attending a tertiary care cardiac hospital in Bangladesh. , 2008, Public health.

[10]  Ron Borland,et al.  Functional beliefs about smoking and quitting activity among adult smokers in four countries: findings from the International Tobacco Control Four-Country Survey. , 2008, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[11]  A. Bhuiya,et al.  Sociodemographic Characteristics of Tobacco Consumers in a Rural Area of Bangladesh , 2007, Journal of health, population, and nutrition.

[12]  R. Malone,et al.  How the health belief model helps the tobacco industry: individuals, choice, and “information” , 2006, Tobacco Control.

[13]  K. Peltzer,et al.  Traditional Healers' Perceptions of Smokeless Tobacco Use and Health in the Limpopo Province of South Africa , 2006, Substance use & misuse.

[14]  P. Gupta,et al.  Smokeless Tobacco Use and Risk of Stillbirth: A Cohort Study in Mumbai, India , 2006, Epidemiology.

[15]  P. Gupta,et al.  Smokeless tobacco use, birth weight, and gestational age: population based, prospective cohort study of 1217 women in Mumbai, India , 2004, BMJ : British Medical Journal.

[16]  M. Rani,et al.  Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey , 2003, Tobacco control.

[17]  P. Gupta,et al.  INVITED REVIEW SERIES: TOBACCO AND LUNG HEALTH Smokeless tobacco and health in India and South Asia , 2003 .

[18]  Poul Erik Petersen,et al.  The World Oral Health Report 2003: continuous improvement of oral health in the 21st century--the approach of the WHO Global Oral Health Programme. , 2003, Community dentistry and oral epidemiology.

[19]  N. Ali.  Prediction of Coronary Heart Disease Preventive Behaviors in Women: A Test of the Health Belief Model , 2002, Women & health.

[20]  J. Townsend,et al.  Hungry for tobacco: an analysis of the economic impact of tobacco consumption on the poor in Bangladesh , 2001, Tobacco control.

[21]  K. Maneechotesuwan.  An exotic pulmonary infection in Thailand: Melioidosis , 1999, Respirology.

[22]  S. Chakravorty,et al.  Cessation related perceptions and behavior of former and current smokeless tobacco users. , 1997, Journal of American college health : J of ACH.

[23]  P D Mullen,et al.  A meta-analysis of studies of the Health Belief Model with adults. , 1992, Health education research.

[24]  S. Krishnamurthy.  Strengh of association of increased placental weight and smokeless tobacco use in pregnancy , 1991, Indian journal of pediatrics.

[25]  N. Pearce,et al.  White Swans, Black Ravens, and Lame Ducks: Necessary and Sufficient Causes in Epidemiology , 1990, Epidemiology.

[26]  A. Milton,et al.  Smokeless tobacco consumption in the South Asian population of Sydney, Australia: prevalence, correlates and availability. , 2014, Drug and alcohol review.

[27]  Z. Fatmi,et al.  Chewing of betel, areca and tobacco: perceptions and knowledge regarding their role in head and neck cancers in an urban squatter settlement in Pakistan. , 2006, Asian Pacific journal of cancer prevention : APJCP.