Tobacco use and nicotine dependency in a cross-sectional representative sample of 18,018 individuals in Andaman and Nicobar Islands, India
Tóm tắt
Data on prevalence, pattern of tobacco use, proportion of population dependent on nicotine and their determinants are important for developing and implementing tobacco control strategies. The aim of the study was to estimate the prevalence and determinants of tobacco use and nicotine dependency. A cross-sectional survey among a representative sample of 18,018 individuals in the age group of >=14 years was conducted in the Union Territory of Andaman and Nicobar Islands during 2007–09. A structured questionnaire, a modified version of an instrument which was used successfully in several multi-country epidemiological studies of the World Health Organisation, was used to survey individual socio-demographic details, known co-morbid conditions, tobacco use and alcohol use. Fagerström Test for Nicotine Dependence (FTND) was used to estimate nicotine dependence. The response rate of our survey was 97% (18,018/18,554). Females (n = 8,888) were significantly younger than males (34.3 + 14.6 Vs 36.2 + 15.4 years). The prevalence of current tobacco use in any form was 48.9% (95% CI: 48.2–49.6). Tobacco chewing alone was prevalent in 40.9% (95% CI: 40.1–41.6) of the population. While one tenth of males (9.7%, 95% CI: 9.1–10.4) were nicotine dependent, it was only 3% (95% CI: 2.7–3.4) in females. Three fourth of the tobacco users initiated use of tobacco before reaching 21 years of age. Age, current use of alcohol, poor educational status, marital status, social groups, and co-morbidities were the main determinants of tobacco use and nicotine dependence in the population. The high prevalence of tobacco use especially the chewing form of tobacco in the Union Territory of Andaman and Nicobar Islands and the differences in prevalence and pattern of tobacco use and nicotine dependency observed across subgroups warrants implementation of culturally specific tobacco control activities in this population.
Tài liệu tham khảo
Shafey O, Erikson M, Ross H, Mackay J: The Tobacco Atlas. 2009, American Cancer Society, Atlanta, 3
Thankappan KR, Mini GK: Case–control study of smoking and death in India. N Engl J Med. 2008, 358 (26): 2842-2843.
Tobacco use in India: Practices, Patterns and Prevalence. Report on Tobacco Control in India. Edited by: Reddy KS, Gupta PC. 2004, Ministry of Health and Family Welfare, Government of India, New Delhi, India
World Health Organization: Global Adult Tobacco Survey (GATS) India Report. 2009, Available at whoindia.org/EN/Section20/Section25_1861.htm (accessed on 19 February 2012), –2010
Hatsukami DK, Stead LF, Gupta PC: Tobacco addiction. Lancet. 2008, 371 (9629): 2027-2038. 10.1016/S0140-6736(08)60871-5.
Andaman and Nicobar Administration: Know Andaman. Available at www.and.nic.in/andaman/knowabt.php (accessed on 19 February 2012)
Benegal V, Nayak M, Murthy P, Chandra P, Gururaj G: Women and alcohol use in India. Alcohol, gender and drinking problems. Edited by: Obot IS, Room R. 2005, World Health Organization, Geneva, 89-123.
Goldberg DP, Blackwell B: Psychiatric illness in general practice. A detailed study using a new method of case definition. Br Med J. 1970, 1: 439-443.
Golderberg D, Williams P: A user’s guide to the General Health questionnaire. 1988, NFER-Nelson, Windsor, UK
Goldberg D: General Health Questionnaire (GHQ-12). 1992, NFER-Nelson, Windsor, UK
Jacob KS, Bhugra D, Mann AH: The validation of the 12-item General Health questionnaire in ethnic Indian women living in the United Kingdom. Psychol Med. 1997, 27: 1215-1217. 10.1017/S0033291796004436.
Kuruvilla A, Pothen M, Philip K, Braganza D, Joseph A, Jacob KS: The validation of the Tamil version of the 12 item general health questionnaire. Indian J Psychiatry. 1999, 41: 217-221.
Brewin CR, Rose S, Andrews B, Green J, Tata P, McEvedy C, Turner S, Foa EB: Brief screening instrument for post-traumatic stress disorder. Br J Psychiatry. 2002, 181: 158-162.
First MB, Spitzer RL, Gibbon M, Williams JBW: Structured Clinical Interview for DSM-IV Axis I Disorders. Clinician Version (SCID-CV). 1996, American Psychiatric Press, Inc, Washington DC
Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusmen FD, Charney DS, Keane TM: The development of a clinician administered PTSD scale. J Trauma Stress. 1995, 8: 75-90. 10.1002/jts.2490080106.
Heatherton TF, Kozlowski LT, Frecker RC, Fagerström KO: The Fagerström Test for Nicotine Dependence: a revision of the Fagerström Tolerance Questionnaire. Br J Addict. 1991, 86 (9): 1119-1127. 10.1111/j.1360-0443.1991.tb01879.x.
Ebbert JO, Patten CA, Schroeder DR: The Fagerström Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST). Addict Behav. 2006, 31: 1716-1721. 10.1016/j.addbeh.2005.12.015.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. 2000, American Psychiatric Association, Washington, DC
World Health Organization: The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic Criteria for Research. 1993, World Health Organization, Geneva, Switzerland
Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG: AUDIT. The Alcohol Use Disorders Identification Test: Guidelines for Use in Primary Health Care (Second Edition). 2001, World Health Organization, Geneva
Rooban T, Elizabeth J, Umadevi KR, Ranganathan K: Sociodemographic correlates of male chewable smokeless tobacco users in India: a preliminary report of analysis of National Family Health Survey, 2005–2006. Indian J Cancer. 2010, 47 (Suppl 1): 91-100.
Meneses-Gaya IC, Zuardi AW, Loureiro SR, Crippa JA: Psychometric properties of the Fagerström Test for Nicotine Dependence. J Bras Pneumol. 2009, 35 (1): 73-82. 10.1590/S1806-37132009000100011.
Nicobar District: Andaman and Nicobar Islands. Available at www.nicobar.nic.in (accessed on 19 February 2012)
Directorate of Economics and Statistics: Andaman and Nicobar Administration. Basic Statistics 2006–07. 2007, Directorate of Economics and Statistics. Andaman and Nicobar Administration, Port Blair
Westermeyer J: The role of ethnicity in substance abuse. Adv Alcohol Subst Abuse. 1984, 4: 9-18. 10.1300/J251v04n01_02.
Macionis JJ, Gerber LM: Sociology. 2010, Pearson Canada, Toronto, 97-
Breslau N: Psychiatric comorbidity of smoking and nicotine dependence. Behav Genet. 1995, 25: 95-101. 10.1007/BF02196920.
Rani M, Bonu S, Jha P, Nguyen SN, Jamjoum L: Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey. Tob Control. 2003, 12 (4): e4-10.1136/tc.12.4.e4.
Reddy KS, Prabhakaran D, Jeemon P, Thankappan KR, Joshi P, Chaturvedi V, Ramakrishnan L, Ahmed F: Educational status and cardiovascular risk profile in Indians. Proc Natl Acad Sci U S A. 2007, 104 (41): 16263-16268. 10.1073/pnas.0700933104.
Jeemon P, Reddy KS: Social determinants of cardiovascular disease outcomes in Indians. Indian J Med Res. 2010, 132 (5): 617-622.
The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2458/12/515/prepub
