Spatial Pattern and Determinants of Tobacco Use Among Females in India: Evidence From a Nationally Representative Survey

Abstract Introduction Tobacco use has been steadily increasing among the females in developing countries. It has led to rise in tobacco–related morbidity and mortality among females. Knowing the geographic distribution of the habit is essential to identify high–priority areas and direct the healthcare intervention. Hence, this study was done to assess the spatial patterns and determinants of tobacco consumption among females in India. Aims and Methods Univariate and bivariate Moran’s I statistic and local indicators for spatial association maps were generated to determine the spatial clustering of tobacco consumption (smoked and smokeless form). Ordinary least-square regression, spatial-lag and spatial-error models were performed to assess the determinants. Poverty (belonging to poorest and poorer quintile of wealth index), illiteracy (no formal education), marital status, ST population, tobacco use by family members, and alcohol use were the explanatory variables. Results Univariate Moran’s I was .691 suggesting positive spatial autocorrelation. High–prevalence clustering (hotspots) was maximum in the central, eastern, and northeastern states such as Chhattisgarh, Madhya Pradesh, Odisha, Bihar, Manipur, Tripura, Meghalaya, Mizoram, and Assam. This pattern was similar for both smokeless and smoked form. Results of spatial-lag and spatial-error model suggested that alcohol use, scheduled tribes, illiteracy, poverty, marital status, and tobacco use by family members were significant determinants of female tobacco consumption. The coefficient of spatial association was maximum for alcohol use (β = .20, p < .001) followed by widowed/separated/divorced (β = .12, p < .001). Conclusions Tobacco consumption among females in India is spatially clustered. Multisectoral coordination and targeted interventions are required in the geographical hotspots of tobacco consumption. Implications This is the first study to explore the geospatial pattern of tobacco consumption among females in India. We found that the pattern of tobacco use among females is spatially clustered in India. Clustering was predominantly found in central, eastern, and northeastern regions of the country. Tribal population in these areas and complementarities between alcohol and tobacco use contributed significantly to the high–prevalence clustering. These findings will be helpful for policymakers and planners to devise specific intervention package targeting the high–risk regions.

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Alcohol and Tobacco Use in a Tuberculosis Treatment Cohort during South Africa’s COVID-19 Sales Bans: A Case Series

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105449 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5449

Author(s):

Bronwyn Myers ◽

Tara Carney ◽

Jennifer Rooney ◽

Samantha Malatesta ◽

Laura F. White ◽

...

Keyword(s):

Alcohol Use ◽

Tobacco Use ◽

Heavy Drinking ◽

Case Series ◽

Tobacco Consumption ◽

Tuberculosis Treatment ◽

Behavior Change Interventions ◽

Patterns Of Drinking ◽

Tobacco Ban ◽

Drinking Occasion

Background: South Africa temporarily banned alcohol and tobacco sales for about 20 weeks during the COVID-19 lockdown. We described changes in alcohol and tobacco consumption after implementation of these restrictions among a small number of participants in a tuberculosis treatment cohort. Method: The timeline follow-back procedure and Fägerstrom test for nicotine dependence was used to collect monthly alcohol and tobacco use information. We report changes in heavy drinking days (HDD), average amount of absolute alcohol (AA) consumed per drinking day, and cigarettes smoked daily during the alcohol and tobacco ban compared to use prior to the ban. Results: Of the 61 participants for whom we have pre-ban and within-ban alcohol use information, 17 (27.9%) reported within-ban alcohol use. On average, participants reported one less HDD per fortnight (interquartile range (IQR): −4, 1), but their amount of AA consumed increased by 37.4 g per drinking occasion (IQR: −65.9 g, 71.0 g). Of 53 participants who reported pre-ban tobacco use, 17 (32.1%) stopped smoking during the ban. The number of participants smoking >10 cigarettes per day decreased from 8 to 1. Conclusions: From these observations, we hypothesize that policies restricting alcohol and tobacco availability seem to enable some individuals to reduce their consumption. However, these appear to have little effect on the volume of AA consumed among individuals with more harmful patterns of drinking in the absence of additional behavior change interventions.

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High prevalence of tobacco use, alcohol use and overweight in a rural population in Tamil Nadu, India

Journal of Postgraduate Medicine ◽

10.4103/0022-3859.74284 ◽

2011 ◽

Vol 57 (1) ◽

pp. 9 ◽

Cited By ~ 17

Author(s):

P Kaur ◽

SR Rao ◽

E Radhakrishnan ◽

R Ramachandran ◽

R Venkatachalam ◽

...

Keyword(s):

Alcohol Use ◽

Tobacco Use ◽

Rural Population ◽

Tamil Nadu ◽

High Prevalence

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Predicting Tobacco and Alcohol Consumption Based on Physical Activity Level and Demographic Characteristics in Romanian Students

Children ◽

10.3390/children7070071 ◽

2020 ◽

Vol 7 (7) ◽

pp. 71 ◽

Cited By ~ 2

Author(s):

Georgian Badicu ◽

Seyed Hojjat Zamani Sani ◽

Zahra Fathirezaie

Keyword(s):

Physical Activity ◽

Alcohol Consumption ◽

Alcohol Use ◽

Significant Relationship ◽

Physical Activity Level ◽

Short Form ◽

Tobacco Consumption ◽

Demographic Characteristics ◽

Activity Level ◽

High Prevalence

Background: This study aims to assess the relationships between alcohol and tobacco consumption, physical activity (PA) and demographic characteristics in Romanian students. Methods: There were 253 participants in this study (112 male and 141 female, age 19.2 ± 0.70 yrs; BMI 22.4 ± 2.2 kg/m2), students of Transilvania University of Brasov. The International Physical Activity Questionnaire Short Form (IPAQ-SF), Alcohol Use Disorders Identification Test (AUDIT) and Fagerström Test for Nicotine Dependence (FTND) were employed for the data collection. Results: Results showed that moderate consumption of tobacco and harmful consumption of alcohol had high prevalence among age, gender, year of study and PA level categories. Although the correlation coefficient showed no significant relationship between tobacco and alcohol use, it was shown that a negative correlation between tobacco and PA level existed. Further, age, year of study and PA level had a negative significant relationship with alcohol use among students. In the end, the tobacco and alcohol consumption prediction model showed heterogeneous coefficients. Conclusion: Full models of tobacco and alcohol use were differently predicted by variables, so PAL (Physical Activity Level) could predict tobacco consumption but not alcohol.

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Conjoint alcohol and tobacco use among tuberculosis patients in public primary healthcare in South Africa

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v20i1.482 ◽

2014 ◽

Vol 20 (1) ◽

pp. 6 ◽

Cited By ~ 5

Author(s):

Karl Peltzer

Keyword(s):

South Africa ◽

Alcohol Use ◽

Tobacco Use ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Tb Treatment ◽

Patient Status ◽

High Prevalence ◽

Audit Score ◽

Alcohol Users

Objective. To determine the prevalence of, and factors associated with conjoint alcohol and tobacco use among tuberculosis (TB) patients in South Africa (SA).Methods. In a cross-sectional survey, 4 900 (54.5% men, 45.5% women) consecutively selected TB patients (including new TB and new TB retreatment patients) from 42 public primary care clinics in three districts in SA were assessed using various measures (including those for alcohol and tobacco use), within one month of anti-TB treatment.Results. Overall, 10.1% (15.5% among men; 3.4% among women) were conjointly hazardous, harmful or dependent alcohol users and daily or almost-daily tobacco users. The proportion of daily or almost-daily tobacco users among hazardous, harmful or dependent alcohol users was 48.9%, (53.3% among men; 26.4% among women). Those with hazardous, harmful or dependent alcohol use had significantly higher odds of having anxiety and/or depression (odds ratio (OR) 1.37; confidence interval (CI) 1.13 - 1.65) and exhibiting daily or almost-daily tobacco use (OR 5.94; CI 4.33 - 5.87). The mean ± standard deviation alcohol use disorders identification test (AUDIT) score among conjoint hazardous, harmful or dependent alcohol users and daily or almost-daily tobacco users was significantly higher (17.1±6.1) than among hazardous, harmful or dependent alcohol users who were not current tobacco users (15.4±5.6) (p<0.001). In multivariate analysis, male gender, coloured ethnicity, lower education and greater poverty, TB retreatment patient status and non-adherence to anti-TB medication were associated with a greater risk for conjoint alcohol and tobacco use.Conclusions. A high prevalence and several risk factors for conjoint alcohol and tobacco use were found among TB patients. The findings of this study call for dual-intervention approaches to alcohol and tobacco use.

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Tobacco and Alcohol Consumption Rates among Chinese Women of Reproductive Age in 2004–2011: Rate and Sociodemographic Influencing Factors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16010056 ◽

2018 ◽

Vol 16 (1) ◽

pp. 56 ◽

Cited By ~ 3

Author(s):

Ruiyi Liu ◽

Li Chen ◽

Huan Zeng ◽

Cesar Reis ◽

Haley Reis ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Educational Attainment ◽

Marital Status ◽

Chinese Women ◽

Alcoholic Beverage ◽

Tobacco Consumption ◽

Reproductive Age ◽

Consumption Rates ◽

Drinking Behaviors

Background: Smoking and alcohol consumption have become major public health problems among Chinese women. In this study we explore the behavioral trends in smoking and alcohol consumption of Chinese women. We also explored the changes in the sociodemographic factors that affect the smoking and alcohol consumption behaviors of Chinese women at different reproductive stages. Methods: We used the Chinese Health and Nutrition Survey data for 2004 to 2011 to investigate the trends and influential factors of tobacco and alcohol consumption among Chinese women. Data for tobacco and alcohol consumption (consumption of beer or any other alcoholic beverage and smoking of cigarettes) were extracted using questionnaires. We applied the χ2 test to examine the trends of alcohol and tobacco consumption among Chinese women over the period of 2004 to 2011. We conducted two penalized logistic regressions with age as the continuous and classification variable (18–23, 24–29, 30–44, and 45–49 years), and independent variables included residence, age, and marital status. Results: Drinking rates among Chinese women significantly changed over the period of 2004 to 2011 (p = 0.018). Age was related to tobacco consumption rates for 2009 and 2011 (p < 0.05). Marital status was associated with tobacco consumption rates for 2004, 2009, and 2011 (p < 0.05). Tobacco and alcohol consumption rates from 2004 to 2011 were positively correlated (p < 0.05). Over the period of 2004 to 2011, alcohol consumption rates were higher among women living in urban areas than those among women living in rural areas (p < 0.05). High educational attainment was related to alcohol consumption. Educational attainment levels of secondary or primary schooling and university or above were related to alcohol consumption rates for 2004 to 2011 (p < 0.05). Employed women were more likely to consume alcohol than unemployed women in 2004, 2006, and 2011 (p < 0.05). Data from 2004 to 2011 showed that tobacco and alcohol use were correlated (p < 0.05) and that women aged 45–49 years old were more likely to consume tobacco than other women (p < 0.05); Conclusions: The drinking behavior of Chinese women changed considerably over the period of 2004 to 2011. Our results provide further insight on the smoking and drinking behaviors of Chinese women at different reproductive stages and the factors that influence such behaviors. Therefore, our findings on trends and factors that influence rates of tobacco and alcohol use allow for a better understanding of the smoking and drinking behaviors of Chinese women.

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Age and marital status predictors of binge alcohol use among adults with major depressive episode

10.31234/osf.io/e7w6y ◽

2020 ◽

Author(s):

Areen Omary

Keyword(s):

At Risk ◽

Alcohol Use ◽

Marital Status ◽

Depressive Episode ◽

Major Depressive Episode ◽

Age Groups ◽

Future Research ◽

Major Depressive ◽

Never Married ◽

At Risk Populations

Aims: This study aims to examine if age and marital status can predict the risk for binge alcohol use (BAU) among adults with a major depressive episode (MDE). Methods: Data from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2018 National Survey for Drug Use and Health (NSDUH) were analyzed. The unweighted sample included 6,999 adults representing a weighted population size of 33,900,452.122 in the US. Results and Conclusions: The findings of this retrospective research confirmed that age and marital status significantly predicted BAU in the past month among adults with MDE. Adults with MDE at higher risk for BAU were adults under the age of 50, adults who were never married, and adults who were divorced/separated. Special attention must be paid to those in age groups under 50, never married, and have been separated/divorced who are particularly at-risk for future alcohol abuse. Future research should consider examining additional potential confounders for BAU among other at-risk populations.

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Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis

Children ◽

10.3390/children8020133 ◽

2021 ◽

Vol 8 (2) ◽

pp. 133

Author(s):

Perpetua Modjadji ◽

Mpinane Pitso

Keyword(s):

South Africa ◽

Alcohol Use ◽

Tobacco Use ◽

Child Growth ◽

Growth Patterns ◽

World Health ◽

Poor Growth ◽

Growth Standards ◽

Validated Questionnaire ◽

Current Tobacco

Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.

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Concurrent Childhood Experiences Impact Underage Substance Use

Child Maltreatment ◽

10.1177/10775595211012480 ◽

2021 ◽

pp. 107755952110124

Author(s):

Eliza Broadbent ◽

Jacob Read Miller ◽

Aaron Cheung ◽

Elizabeth Mathews Rollins ◽

Lynneth Kirsten B. Novilla ◽

...

Keyword(s):

Substance Use ◽

Alcohol Use ◽

Tobacco Use ◽

Early Initiation ◽

Adolescent Substance Use ◽

Late Adolescent ◽

Childhood Experiences ◽

Adolescent Substance ◽

The Cross

Adverse and advantageous childhood experiences (ACEs and counter-ACEs) during adolescence are understudied. This study examined how childhood experiences affect youth tobacco/alcohol use. Participants included 489 U.S. adolescents (baseline 10–13 years; 51% female) from the first five waves of the Flourishing Families Project. Results of the cross-lagged model showed ACEs were predictive of early tobacco use only. Counter-ACEs in wave two and wave three predicted, respectively, decreased tobacco and decreased alcohol use in the following wave. Counter-ACEs were also correlated with reduced alcohol and tobacco use in later waves. These findings indicate the salience of counter-ACEs over ACEs in persistent and late adolescent substance use, though ACEs may be important to consider to prevent very early initiation of tobacco.

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Patterns of Periodontal Destruction among Smokeless Tobacco Users in a Central Indian Population

Healthcare ◽

10.3390/healthcare9060744 ◽

2021 ◽

Vol 9 (6) ◽

pp. 744

Author(s):

Pradeep S. Anand ◽

Supriya Mishra ◽

Deepti Nagle ◽

Namitha P. Kamath ◽

Kavitha P. Kamath ◽

...

Keyword(s):

Smokeless Tobacco ◽

Tobacco Consumption ◽

Periodontal Health ◽

Clinical Attachment Loss ◽

Periodontal Tissues ◽

Probing Depth ◽

High Prevalence ◽

Periodontal Destruction ◽

Different Populations ◽

Oral Hygiene Habits

Background: Findings of studies testing the association between smokeless tobacco (SLT) use and periodontal health have shown varying results in different populations. Considering the high prevalence of SLT use in India, the present study was conducted to understand the pattern of periodontal destruction within different areas of the dentition among SLT users. Methods: Age, gender, oral hygiene habits, the frequency and duration of SLT consumption, the type of SLT product used, and the site of retention of the SLT product in the oral cavity were recorded among 90 SLT users. Probing depth (PD), recession (REC), and clinical attachment loss (CAL) at SLT-associated and non SLT-associated teeth of the mandibular arch were compared based on the site of retention of the SLT product, the type of product used, and the duration of the habit. Results: REC and CAL were significantly higher at the SLT-associated zones compared to non SLT-associated zones and at both interproximal and mid-buccal sites of SLT-associated teeth. Among individuals who had the habit for more than 5 years and also among those who had the habit for 5–10 years, PD, REC, and CAL were significantly higher at SLT-associated teeth than at non SLT-associated teeth. Significantly greater periodontal destruction was observed at SLT-associated teeth among khaini users and gutkha users. Conclusions: Smokeless tobacco consumption resulted in greater destruction of periodontal tissues. The severity of periodontal destruction at SLT-associated sites differed depending on the type of smokeless tobacco used, the site of retention of the SLT, and the duration of the habit.

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Socioeconomic inequalities in lifestyle risk factors across low- and middle-income countries

10.21203/rs.3.rs-307966/v1 ◽

2021 ◽

Author(s):

Charlotte Dieteren ◽

Igna Bonfrer

Keyword(s):

Risk Factors ◽

Alcohol Use ◽

Tobacco Use ◽

Socioeconomic Inequalities ◽

Middle Income ◽

Lifestyle Risk Factors ◽

Middle Income Countries ◽

The Poor ◽

Harmful Alcohol ◽

Lifestyle Risk

Abstract Background The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce their underlying risk factors, which are often linked to lifestyles. To effectively supplement nationwide policies with targeted interventions, it is important to know how these risk factors are distributed across socioeconomic segments of populations in LMICs. This study quantifies the prevalence and socioeconomic inequalities in lifestyle risk factors in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030. Methods Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with the different lifestyle risk factors. Results The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively − 0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off. The associations between the share of GDP spent on health and the socioeconomical distribution of lifestyle factors are multidirectional. Conclusions This study emphasizes the importance of lifestyle risk factors in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in lifestyle risk factors - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted to supplement nationwide policies.

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