TY - JOUR
T1 - A cross-sectional study of the prevalence and correlates of tobacco Use in Chennai, Delhi, and Karachi
T2 - Data from the CARRS study
AU - Berg, Carla J.
AU - Ajay, Vamadevan S.
AU - Ali, Mohammed K.
AU - Kondal, Dimple
AU - Khan, Hassan M.
AU - Shivashankar, Roopa
AU - Pradeepa, Rajendra
AU - Mohan, Deepa
AU - Fatmi, Zafar
AU - Kadir, Muhammad M.
AU - Tandon, Nikhil
AU - Mohan, Viswanathan
AU - Narayan, Km Venkat
AU - Prabhakaran, Dorairaj
N1 - Funding Information:
This study is coordinated by Centre of Excellence – Centre for Cardiometabolic Risk Reduction in South Asia (CoECARRS) based at Public Health Foundation of India (PHFI), New Delhi, India in collaboration with Centre for Chronic Disease Control (CCDC), New Delhi, Emory University, Atlanta, U.S.A, All India Institute of Medical Sciences (AIIMS), New Delhi, Madras Diabetes Research Foundation (MDRF), Chennai, India and Aga Khan University, Karachi, Pakistan. We hereby, acknowledge the contributions of the field and research staff of the “CARRS Surveillance Investigators’ Group” (a list of all members is included below). This project is funded in whole or in part by the National Heart, Lung, and Blood Institute, National Institutes of Health (NIH), Department of Health and Human Services, under Contract No. HHSN268200900026C, and the United Health Group, Minneapolis, Mn, USA. Several members of the research team at PHFI, Emory University, and CCDC were/are supported by the Fogarty International Clinical Research Scholars – Fellows programme (FICRSF) through Grant Number 5R24TW007988 from NIH, Fogarty International Center (FIC) through Vanderbilt University, Emory’s Global Health Institute, and D43 NCDs in India Training Program through Award Number 1D43HD05249 from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD) and FIC. However, the contents of this paper are solely the responsibility of the writing group (listed below) and do not necessarily represent the official views of FIC, Vanderbilt University, Emory University, PHFI, NICHD, or the NIH. COECARRS Surveillance Investigators’ Group. Steering Committee: Dorairaj Prabhakaran, K. M. Venkat Narayan, K Srinath Reddy, Nikhil Tandon, V. Mohan, Muhammed M. Kadir, Mohammed K. Ali, Vamadevan S Ajay. Operations: Dorairaj Prabhakaran, Nikhil Tandon, K. M. Venkat Narayan, Mohammed K Ali, Muhammed M. Kadir, S. Roopa, Hassan M. Khan, R. Anjana RM, Pradeepa, M. Deepa, Vamadevan S Ajay, Dimple Kondal, Ruby Gupta, Pragya Sharma. Coordinating Centre (Delhi): Dorairaj Prabhakaran, Nikhil Tandon, S. Roopa, Vamadevan S Ajay, Manisha Nair, Nivedita Devasenapathy, Divya Pillai Development of questionnaires and manual of operations: Dorairaj Prabhakaran, Nikhil Tandon, K. M. Venkat Nararayan, Mohammed K. Ali, Manisha Nair, Nivedita Devasenapathy, R. Pradeepa , Ed Gregg, Anwar Merchant, Romaina Iqbal. Data management and statistical team: Dimple Kondal, Shivam Pandey, Praggya, Naveen.
Publisher Copyright:
© 2015 Berg et al.; licensee BioMed Central.
PY - 2015/5/11
Y1 - 2015/5/11
N2 - Background: Tobacco burdens in India and Pakistan require continued efforts to quantify tobacco use and its impacts. We examined the prevalence and sociodemographic and health-related correlates of tobacco use in Delhi, Chennai (India), and Karachi (Pakistan). Methods: Analysis of representative surveys of 11,260 participants (selected through multistage cluster random sampling; stratified by gender and age) in 2011 measured socio-demographics, tobacco use history, comorbid health conditions, and salivary cotinine. We used bivariate and multivariate regression analyses to examine factors associated with tobacco use. Results: Overall, 51.8 % were females, and 61.6 % were below the age of 45 years. Lifetime (ever) tobacco use prevalence (standardized for world population) was 45.0 %, 41.3 %, and 42.5 % among males, and 7.6 %, 8.5 %, and 19.7 % among females in Chennai, Delhi, and Karachi, respectively. Past 6 month tobacco use prevalence (standardized for world population) was 38.6 %, 36.1 %, and 39.1 % among males, and 7.3 %, 7.1 %, and 18.6 % among females in Chennai, Delhi, and Karachi, respectively. In multivariable regression analyses, residing in Delhi or Karachi versus Chennai; older age; lower education; earning less income; lower BMI; were each associated with tobacco use in both sexes. In addition, semi-skilled occupation versus not working and alcohol use were associated with tobacco use in males, and having newly diagnosed dyslipidemia was associated with lower odds of tobacco use among females. Mean salivary cotinine levels were higher among tobacco users versus nonusers (235.4; CI: 187.0-283.8 vs. 29.7; CI: 4.2, 55.2, respectively). Conclusion: High prevalence of tobacco use in the South Asian region, particularly among men, highlights the urgency to address this serious public health problem. Our analyses suggest targeted prevention and cessation interventions focused on lower socioeconomic groups may be particularly important.
AB - Background: Tobacco burdens in India and Pakistan require continued efforts to quantify tobacco use and its impacts. We examined the prevalence and sociodemographic and health-related correlates of tobacco use in Delhi, Chennai (India), and Karachi (Pakistan). Methods: Analysis of representative surveys of 11,260 participants (selected through multistage cluster random sampling; stratified by gender and age) in 2011 measured socio-demographics, tobacco use history, comorbid health conditions, and salivary cotinine. We used bivariate and multivariate regression analyses to examine factors associated with tobacco use. Results: Overall, 51.8 % were females, and 61.6 % were below the age of 45 years. Lifetime (ever) tobacco use prevalence (standardized for world population) was 45.0 %, 41.3 %, and 42.5 % among males, and 7.6 %, 8.5 %, and 19.7 % among females in Chennai, Delhi, and Karachi, respectively. Past 6 month tobacco use prevalence (standardized for world population) was 38.6 %, 36.1 %, and 39.1 % among males, and 7.3 %, 7.1 %, and 18.6 % among females in Chennai, Delhi, and Karachi, respectively. In multivariable regression analyses, residing in Delhi or Karachi versus Chennai; older age; lower education; earning less income; lower BMI; were each associated with tobacco use in both sexes. In addition, semi-skilled occupation versus not working and alcohol use were associated with tobacco use in males, and having newly diagnosed dyslipidemia was associated with lower odds of tobacco use among females. Mean salivary cotinine levels were higher among tobacco users versus nonusers (235.4; CI: 187.0-283.8 vs. 29.7; CI: 4.2, 55.2, respectively). Conclusion: High prevalence of tobacco use in the South Asian region, particularly among men, highlights the urgency to address this serious public health problem. Our analyses suggest targeted prevention and cessation interventions focused on lower socioeconomic groups may be particularly important.
KW - Population studies
KW - Secondhand smoke exposure
KW - Southeast Asia
KW - Tobacco use
UR - http://www.scopus.com/inward/record.url?scp=84929331657&partnerID=8YFLogxK
U2 - 10.1186/s12889-015-1817-z
DO - 10.1186/s12889-015-1817-z
M3 - Article
C2 - 25958327
AN - SCOPUS:84929331657
SN - 1472-698X
VL - 15
JO - BMC Public Health
JF - BMC Public Health
IS - 1
M1 - 483
ER -
