Smokeless tobacco use, Knowledge on health harms of smokeless tobacco use and family socioeconomic status among youth: findings from the international tobacco control India Survey
Karjalainen-Goenka, Anu (2021)
2021
Kansanterveystieteen maisteriohjelma - Master's Programme in Public Health
Yhteiskuntatieteiden tiedekunta - Faculty of Social Sciences
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Hyväksymispäivämäärä
2021-05-18
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-202105074632
https://urn.fi/URN:NBN:fi:tuni-202105074632
Tiivistelmä
There are only a few studies indicating that youth with low socioeconomic status (SES) use smokeless tobacco (SLT) more than youth with high SES. Furthermore, low SES seems to be negatively associated with knowledge on the health harms of SLT use. However, the association is not known among Indian youth. Youth who have knowledge on the health harms of SLT use seem to use less SLT, but the evidence is insufficient and weak. This study examines differences in SLT use and knowledge on the health harms of SLT use among youth (aged 15-24 years) with different SES (a composite of the monthly household income and the level of education of youth).
The data for this cross-sectional study was retrieved from International Tobacco Control Project (TCP) India, Wave 2 follow-up survey (2012-2013). The survey was conducted among tobacco users and non-users aged 15 years and older from four urban cities and their surrounding rural districts. However, the present analysis was restricted to SLT-, mixed (both smokeless and smoked tobacco products)- and never SLT users aged 15–24 years in Bihar (N=580), West Bengal (N=295), Madhya Pradesh (N=371) and Maharashtra (N=281). The association between SES and SLT use (I), SES and the knowledge (II) and the knowledge and SLT use among all youth, youth with low SES and youth with high SES separately (III) were assessed by Pearson chi-square test. Logistic regression analyses were used to assess the bi- and multivariable associations for the same.
Youth with low SES used more SLT compared to youth with high SES in Bihar, West Bengal, Madhya Pradesh and Maharashtra. Youth with low SES also knew less on the health harms of SLT use compared to youth with high SES. In all four states, youth who knew on the health harms used less SLT. Stratified analysis indicated that among youth with high SES, those who knew on the health harms used less SLT, but among youth with low SES, no association was found between the knowledge and SLT use.
SLT use is a problem especially among youth with low SES in Bihar, West Bengal, Madhya Pradesh and Maharashtra. This study also demonstrated that inequalities in knowledge on the health harms of SLT use exist between youth from families of low SES and high SES. There is a need to address the disparities as these are unfair and preventable. These findings emphasize the need for providing early education on SLT use prevention focusing on the youth from low SES to reduce the burden of disability and mortality caused by SLT use in all four states.
The data for this cross-sectional study was retrieved from International Tobacco Control Project (TCP) India, Wave 2 follow-up survey (2012-2013). The survey was conducted among tobacco users and non-users aged 15 years and older from four urban cities and their surrounding rural districts. However, the present analysis was restricted to SLT-, mixed (both smokeless and smoked tobacco products)- and never SLT users aged 15–24 years in Bihar (N=580), West Bengal (N=295), Madhya Pradesh (N=371) and Maharashtra (N=281). The association between SES and SLT use (I), SES and the knowledge (II) and the knowledge and SLT use among all youth, youth with low SES and youth with high SES separately (III) were assessed by Pearson chi-square test. Logistic regression analyses were used to assess the bi- and multivariable associations for the same.
Youth with low SES used more SLT compared to youth with high SES in Bihar, West Bengal, Madhya Pradesh and Maharashtra. Youth with low SES also knew less on the health harms of SLT use compared to youth with high SES. In all four states, youth who knew on the health harms used less SLT. Stratified analysis indicated that among youth with high SES, those who knew on the health harms used less SLT, but among youth with low SES, no association was found between the knowledge and SLT use.
SLT use is a problem especially among youth with low SES in Bihar, West Bengal, Madhya Pradesh and Maharashtra. This study also demonstrated that inequalities in knowledge on the health harms of SLT use exist between youth from families of low SES and high SES. There is a need to address the disparities as these are unfair and preventable. These findings emphasize the need for providing early education on SLT use prevention focusing on the youth from low SES to reduce the burden of disability and mortality caused by SLT use in all four states.