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Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Burden of waterpipe smoking and chewing tobacco use among women of reproductive age group using data from the 2012–13 Pakistan Demographic and Health Survey

Authors: Muhammad Tahir Khan, Shahkamal Hashmi, Sidra Zaheer, Syeda Kanwal Aslam, Naveed Ali Khan, Hina Aziz, Nabil Rashid, Kashif Shafique

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Despite the general decline in cigarette smoking, use of alternative forms of tobacco has increased particularly in developing countries. Waterpipe (WP) and Chewing Tobacco (CT) are two such alternative forms, finding their way into many populations. However, the burden of these alternative forms of tobacco and their socio demographic determinants are still unclear. We assessed the prevalence of WP and CT use among women of reproductive age group in Pakistan.

Methods

Data from the most recent Pakistan Demographic and Health Survey 2012–13 (n = 13,558) was used for this analysis. Information obtained from ever married women, aged between 15 and 49 years were analyzed using two separate data subgroups; exclusive WP smokers (total n = 12,995) and exclusive CT users (total n = 12,771). Univariate and Multivariate logistic regression analyses were conducted and results were reported as crude and adjusted Odds Ratio with 95 % confidence intervals.

Results

Prevalence of WP smoking and CT were 4 % and 2 %, respectively. After multivariate adjustments, ever married women who were: older than 35 years (OR; 4.68 95 % CI, 2.62–8.37), were poorest (OR = 4.03, 95 % CI 2.08–7.81), and had no education (OR = 9.19, 95 % CI 5.10–16.54), were more likely to be WP smokers. Similarly, ever married women who were: older than 35 years (OR = 3.19, 95 % CI 1.69–6.00), had no education (OR = 4.94, 95 % CI 2.62–9.33), were poor (OR = 1.64, 95 % CI 1.07–2.48) and had visited health facility in last 12 months (OR = 1.81, 95 % CI 1.22–2.70) were more likely to be CT users as well.

Conclusion

Older women with lower socio-economic profile were more likely to use WP and CT. Focused policies aiming towards reducing the burden of alternate forms of tobacco use among women is urgently needed to control the tobacco epidemic in the country.
Literature
1.
go back to reference Hurt RD, Murphy JG, Dunn WF. Did we finally slay the evil dragon of cigarette smoking in the late 20th century?: unfortunately, the answer is no - the dragon is still alive and well in the 21st century and living in the third world. Shame on us! Chest. 2014;146(6):1438–43.CrossRefPubMed Hurt RD, Murphy JG, Dunn WF. Did we finally slay the evil dragon of cigarette smoking in the late 20th century?: unfortunately, the answer is no - the dragon is still alive and well in the 21st century and living in the third world. Shame on us! Chest. 2014;146(6):1438–43.CrossRefPubMed
2.
go back to reference Maziak W, Taleb ZB, Bahelah R, Islam F, Jaber R, Auf R, et al. The global epidemiology of waterpipe smoking. Tob Control. 2015;24 Suppl 1:i3–12.CrossRefPubMed Maziak W, Taleb ZB, Bahelah R, Islam F, Jaber R, Auf R, et al. The global epidemiology of waterpipe smoking. Tob Control. 2015;24 Suppl 1:i3–12.CrossRefPubMed
4.
go back to reference Akl EA, Gaddam S, Gunukula SK, Honeine R, Jaoude PA, Irani J. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. Int J Epidemiol. 2010;39(3):834–57.CrossRefPubMed Akl EA, Gaddam S, Gunukula SK, Honeine R, Jaoude PA, Irani J. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. Int J Epidemiol. 2010;39(3):834–57.CrossRefPubMed
5.
go back to reference Akl EA, Gunukula SK, Aleem S, Obeid R, Jaoude PA, Honeine R, et al. The prevalence of waterpipe tobacco smoking among the general and specific populations: a systematic review. BMC Public Health. 2011;11(1):244.CrossRefPubMedPubMedCentral Akl EA, Gunukula SK, Aleem S, Obeid R, Jaoude PA, Honeine R, et al. The prevalence of waterpipe tobacco smoking among the general and specific populations: a systematic review. BMC Public Health. 2011;11(1):244.CrossRefPubMedPubMedCentral
6.
go back to reference Tam J, Day HR, Rostron BL, Apelberg BJ. A systematic review of transitions between cigarette and smokeless tobacco product use in the United States. BMC Public Health. 2015;15(1):258.CrossRefPubMedPubMedCentral Tam J, Day HR, Rostron BL, Apelberg BJ. A systematic review of transitions between cigarette and smokeless tobacco product use in the United States. BMC Public Health. 2015;15(1):258.CrossRefPubMedPubMedCentral
7.
go back to reference Nisar N, Billoo N, Gadit AA, Nisar N, Billoo N, Gadit A. Pattern of tobacco consumption among adult women of low socioeconomic community Karachi, Pakistan. J Pak Med Assoc. 2005;55(3):111–4.PubMed Nisar N, Billoo N, Gadit AA, Nisar N, Billoo N, Gadit A. Pattern of tobacco consumption among adult women of low socioeconomic community Karachi, Pakistan. J Pak Med Assoc. 2005;55(3):111–4.PubMed
8.
go back to reference Chaouachi K. The medical consequences of narghile (hookah, shisha) use in the world. Rev Epidemiol Sante Publique. 2007;55(3):165–70.CrossRefPubMed Chaouachi K. The medical consequences of narghile (hookah, shisha) use in the world. Rev Epidemiol Sante Publique. 2007;55(3):165–70.CrossRefPubMed
9.
go back to reference Ishtiaque I, Shafique K, Ul-Haq Z, Shaikh AR, Khan NA, Memon AR, et al. Water-pipe smoking and albuminuria: new dog with old tricks. PLoS ONE. 2014;9:1.CrossRef Ishtiaque I, Shafique K, Ul-Haq Z, Shaikh AR, Khan NA, Memon AR, et al. Water-pipe smoking and albuminuria: new dog with old tricks. PLoS ONE. 2014;9:1.CrossRef
10.
go back to reference Knishkowy B, Amitai Y. Water-pipe (narghile) smoking: an emerging health risk behavior. Pediatrics. 2005;116(1):e113–9.CrossRefPubMed Knishkowy B, Amitai Y. Water-pipe (narghile) smoking: an emerging health risk behavior. Pediatrics. 2005;116(1):e113–9.CrossRefPubMed
11.
go back to reference Gilani SI, Leon DA. Prevalence and sociodemographic determinants of tobacco use among adults in Pakistan: findings of a nationwide survey conducted in 2012. Popul Health Metrics. 2013;11(1):16.CrossRef Gilani SI, Leon DA. Prevalence and sociodemographic determinants of tobacco use among adults in Pakistan: findings of a nationwide survey conducted in 2012. Popul Health Metrics. 2013;11(1):16.CrossRef
13.
go back to reference Rani M, Bonu S, Jha P, Nguyen S, 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.CrossRefPubMedPubMedCentral Rani M, Bonu S, Jha P, Nguyen S, 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.CrossRefPubMedPubMedCentral
14.
go back to reference Humans IWGotEoCRt, Organization WH, Cancer IAfRo: Smokeless tobacco and some tobacco-specific N-nitrosamines, vol. 89. Lyon, France: World Health Organization; 2007. Humans IWGotEoCRt, Organization WH, Cancer IAfRo: Smokeless tobacco and some tobacco-specific N-nitrosamines, vol. 89. Lyon, France: World Health Organization; 2007.
15.
go back to reference Asfar T, Ward KD, Eissenberg T, Maziak W. Comparison of patterns of use, beliefs, and attitudes related to waterpipe between beginning and established smokers. BMC Public Health. 2005;5(1):19.CrossRefPubMedPubMedCentral Asfar T, Ward KD, Eissenberg T, Maziak W. Comparison of patterns of use, beliefs, and attitudes related to waterpipe between beginning and established smokers. BMC Public Health. 2005;5(1):19.CrossRefPubMedPubMedCentral
16.
go back to reference Khalil J, Afifi R, Fouad FM, Hammal F, Jarallah Y, Mohamed M, et al. Women and waterpipe tobacco smoking in the eastern Mediterranean region: allure or offensiveness. Women & health. 2013;53(1):100–16.CrossRef Khalil J, Afifi R, Fouad FM, Hammal F, Jarallah Y, Mohamed M, et al. Women and waterpipe tobacco smoking in the eastern Mediterranean region: allure or offensiveness. Women & health. 2013;53(1):100–16.CrossRef
17.
go back to reference Chaaya M, Jabbour S, El-Roueiheb Z, Chemaitelly H. Knowledge, attitudes, and practices of argileh (water pipe or hubble-bubble) and cigarette smoking among pregnant women in Lebanon. Addict Behav. 2004;29(9):1821–31.CrossRefPubMed Chaaya M, Jabbour S, El-Roueiheb Z, Chemaitelly H. Knowledge, attitudes, and practices of argileh (water pipe or hubble-bubble) and cigarette smoking among pregnant women in Lebanon. Addict Behav. 2004;29(9):1821–31.CrossRefPubMed
18.
go back to reference Azab M, Khabour OF, Alzoubi KH, Anabtawi MM, Quttina M, Khader Y, et al. Exposure of pregnant women to waterpipe and cigarette smoke. Nicotine & Tobacco Research. 2013;15(1):231–7.CrossRef Azab M, Khabour OF, Alzoubi KH, Anabtawi MM, Quttina M, Khader Y, et al. Exposure of pregnant women to waterpipe and cigarette smoke. Nicotine & Tobacco Research. 2013;15(1):231–7.CrossRef
19.
go back to reference Nuwayhid IA, Yamout B, Azar G, Kambris MAK. Narghile (hubble-bubble) smoking, low birth weight, and other pregnancy outcomes. Am J Epidemiol. 1998;148(4):375–83.CrossRefPubMed Nuwayhid IA, Yamout B, Azar G, Kambris MAK. Narghile (hubble-bubble) smoking, low birth weight, and other pregnancy outcomes. Am J Epidemiol. 1998;148(4):375–83.CrossRefPubMed
20.
go back to reference Jacob P, Raddaha AHA, Dempsey D, Havel C, Peng M, Yu L, et al. Nicotine, carbon monoxide, and carcinogen exposure after a single use of a water pipe. Cancer Epidemiol Biomark Prev. 2011;20(11):2345–53.CrossRef Jacob P, Raddaha AHA, Dempsey D, Havel C, Peng M, Yu L, et al. Nicotine, carbon monoxide, and carcinogen exposure after a single use of a water pipe. Cancer Epidemiol Biomark Prev. 2011;20(11):2345–53.CrossRef
21.
go back to reference Shihadeh A. Investigation of mainstream smoke aerosol of the argileh water pipe. Food Chem Toxicol. 2003;41(1):143–52.CrossRefPubMed Shihadeh A. Investigation of mainstream smoke aerosol of the argileh water pipe. Food Chem Toxicol. 2003;41(1):143–52.CrossRefPubMed
22.
go back to reference Steentoft J, Wittendorf J, Andersen J. Tuberculosis and water pipes as source of infection. Ugeskr Laeger. 2006;168(9):904–7.PubMed Steentoft J, Wittendorf J, Andersen J. Tuberculosis and water pipes as source of infection. Ugeskr Laeger. 2006;168(9):904–7.PubMed
23.
go back to reference Bolinder G, Ahlborg B, Lindell J. Use of smokeless tobacco: blood pressure elevation and other health hazards found in a large‐scale population survey. J Intern Med. 1992;232(4):327–34.CrossRefPubMed Bolinder G, Ahlborg B, Lindell J. Use of smokeless tobacco: blood pressure elevation and other health hazards found in a large‐scale population survey. J Intern Med. 1992;232(4):327–34.CrossRefPubMed
24.
25.
go back to reference Stevens VJ, Severson H, Lichtenstein E, Little SJ, Leben J. Making the most of a teachable moment: a smokeless-tobacco cessation intervention in the dental office. Am J Public Health. 1995;85(2):231–5.CrossRefPubMedPubMedCentral Stevens VJ, Severson H, Lichtenstein E, Little SJ, Leben J. Making the most of a teachable moment: a smokeless-tobacco cessation intervention in the dental office. Am J Public Health. 1995;85(2):231–5.CrossRefPubMedPubMedCentral
26.
28.
go back to reference Calverton M. MEASURE DHS, Demographic and Health Survey. Calverton, Maryland: ORC Macro; 1994. Calverton M. MEASURE DHS, Demographic and Health Survey. Calverton, Maryland: ORC Macro; 1994.
29.
go back to reference Lakew Y, Haile D. Tobacco use and associated factors among adults in Ethiopia: further analysis of the 2011 Ethiopian Demographic and Health Survey. BMC Public Health. 2015;15(1):487.CrossRefPubMedPubMedCentral Lakew Y, Haile D. Tobacco use and associated factors among adults in Ethiopia: further analysis of the 2011 Ethiopian Demographic and Health Survey. BMC Public Health. 2015;15(1):487.CrossRefPubMedPubMedCentral
30.
go back to reference Ahmad K, Jafary F, Jehan I, Hatcher J, Khan AQ, Chaturvedi N, et al. Prevalence and predictors of smoking in Pakistan: results of the National Health Survey of Pakistan. Eur J Cardiovasc Prev Rehabil. 2005;12(3):203–8.CrossRefPubMed Ahmad K, Jafary F, Jehan I, Hatcher J, Khan AQ, Chaturvedi N, et al. Prevalence and predictors of smoking in Pakistan: results of the National Health Survey of Pakistan. Eur J Cardiovasc Prev Rehabil. 2005;12(3):203–8.CrossRefPubMed
32.
go back to reference Jawad M, Lee JT, Millett C. The relationship between waterpipe and cigarette smoking in low and middle income countries: cross-sectional analysis of the global adult tobacco survey. PLoS ONE. 2014;9(3):e93097.CrossRefPubMedPubMedCentral Jawad M, Lee JT, Millett C. The relationship between waterpipe and cigarette smoking in low and middle income countries: cross-sectional analysis of the global adult tobacco survey. PLoS ONE. 2014;9(3):e93097.CrossRefPubMedPubMedCentral
33.
go back to reference Samet JM, Yoon S-Y: Gender, women, and the tobacco epidemic. 2010. Samet JM, Yoon S-Y: Gender, women, and the tobacco epidemic. 2010.
34.
go back to reference Aslam SK, Zaheer S, Rao S, Shafique K. Prevalence and determinants of susceptibility to cigarette smoking among school students in Pakistan: secondary analysis of Global Youth Tobacco Survey. Subst Abuse Treat Prevent Policy. 2014;9:10. doi:10.1186/1747-597X-9-10.CrossRef Aslam SK, Zaheer S, Rao S, Shafique K. Prevalence and determinants of susceptibility to cigarette smoking among school students in Pakistan: secondary analysis of Global Youth Tobacco Survey. Subst Abuse Treat Prevent Policy. 2014;9:10. doi:10.​1186/​1747-597X-9-10.CrossRef
35.
go back to reference Woods NF, Lentz M, Mitchell E. The new woman: Health-promoting and health-damaging behaviors. Health Care Women Int. 1993;14(5):389–405.CrossRefPubMed Woods NF, Lentz M, Mitchell E. The new woman: Health-promoting and health-damaging behaviors. Health Care Women Int. 1993;14(5):389–405.CrossRefPubMed
36.
go back to reference Maziak W, Ward K, Soweid RA, Eissenberg T. Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tob Control. 2004;13(4):327–33.CrossRefPubMedPubMedCentral Maziak W, Ward K, Soweid RA, Eissenberg T. Tobacco smoking using a waterpipe: a re-emerging strain in a global epidemic. Tob Control. 2004;13(4):327–33.CrossRefPubMedPubMedCentral
37.
go back to reference Mejia R, Kaplan CP, Alderete E, Gregorich SE, Pérez-Stable EJ. Influence of gender role attitudes on smoking and drinking among girls from Jujuy, Argentina. Prev Med. 2013;57(3):194–7.CrossRefPubMedPubMedCentral Mejia R, Kaplan CP, Alderete E, Gregorich SE, Pérez-Stable EJ. Influence of gender role attitudes on smoking and drinking among girls from Jujuy, Argentina. Prev Med. 2013;57(3):194–7.CrossRefPubMedPubMedCentral
38.
go back to reference Palipudi K, Rizwan S, Sinha D, Andes L, Amarchand R, Krishnan A, et al. Prevalence and sociodemographic determinants of tobacco use in four countries of the World Health Organization: South-East Asia region: Findings from the Global Adult Tobacco Survey. Indian J Cancer. 2014;1:S24–32. Palipudi K, Rizwan S, Sinha D, Andes L, Amarchand R, Krishnan A, et al. Prevalence and sociodemographic determinants of tobacco use in four countries of the World Health Organization: South-East Asia region: Findings from the Global Adult Tobacco Survey. Indian J Cancer. 2014;1:S24–32.
39.
go back to reference Vergnes J-N, Sixou M. Preterm low birth weight and maternal periodontal status: a meta-analysis. Am J Obstet Gynecol. 2007;196(2):135. e131-135. e137.CrossRefPubMed Vergnes J-N, Sixou M. Preterm low birth weight and maternal periodontal status: a meta-analysis. Am J Obstet Gynecol. 2007;196(2):135. e131-135. e137.CrossRefPubMed
40.
go back to reference Brener ND, Kann L, McManus T, Kinchen SA, Sundberg EC, Ross JG. Reliability of the 1999 youth risk behavior survey questionnaire. J Adolesc Health. 2002;31(4):336–42.CrossRefPubMed Brener ND, Kann L, McManus T, Kinchen SA, Sundberg EC, Ross JG. Reliability of the 1999 youth risk behavior survey questionnaire. J Adolesc Health. 2002;31(4):336–42.CrossRefPubMed
Metadata
Title
Burden of waterpipe smoking and chewing tobacco use among women of reproductive age group using data from the 2012–13 Pakistan Demographic and Health Survey
Authors
Muhammad Tahir Khan
Shahkamal Hashmi
Sidra Zaheer
Syeda Kanwal Aslam
Naveed Ali Khan
Hina Aziz
Nabil Rashid
Kashif Shafique
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2433-7

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