PREVELANCE AND PATTERNS OF TOBACCO AND SMOKELESS TOBACCO USAGE AND ASSOCIATED FACTORS AMONG WOMEN IN RURAL KOLAR -A CROSS-SECTIONAL STUDY.

Abstract

Introduction The tobacco pandemic has been identified by the World Health Organization (WHO) as one of the biggest hazards to public health and a top priority for decision-makers in the medical field. This is not just because of the 7 million annual deaths that are linked to it, but also because of the load on the health system, higher out-of-pocket medical costs, and lower quality of life. The fact that four out of five smokers worldwide come from low- and middle-income countries is concerning. Women not only have a shorter latent period between the start of substance use and the onset of drug progression, but they are also more vulnerable to the negative medical, psychological, and social effects, according to epidemiological analysis of several studies. Globally, smoking causes 71% lung cancer,42% chronic respiratory diseases and about 10% cardiovascular disease. In India, tobacco is smoked as beedi, cheroot or in a pipe. The smokeless forms are chewed as raw tobacco leaves /pan masala or inhaled as snuff. Chewing of tobacco products is a risk factor for oral cancers. Further, tobacco consumption was found to be higher among the lower socioeconomic groups. As reported in many studies, Smokeless tobacco products have a high level of toxicity, mutagenicity and cancer-causing elements and roughly 4200 low grade chemicals which would disproportionately affect health. Smokeless tobacco products also cause life threatening complications in reproductive stages of women with adverse pregnancy outcomes (stillbirth, low birth weight). Due to the lack of precise estimates regarding the prevalence of tobacco consumption among women in rural settings in India, the policy makers lack 14 adequate evidence and find it difficult to mobilize the existing resources. There is limited data on the social and behavioural factors that influence the use of various forms of tobacco and attitudes of tobacco users towards quitting the habit.Hence there is a need to study the Prevalence and associated factors of tobacco use in the form of smoking only, smokeless tobacco only and dual use among rural women in Kolar. Objectives: 1. To determine the prevalence and patterns of tobacco usage among women in rural Kolar. 2. To assess the factors associated with initiation and quitting of tobacco usage among women in rural Kolar. Materials and Methods: • A community-based cross-sectional study was conducted in the field practice area of the Primary Health Center (PHC) Devarayasamudra, Mulbagal Taluk, Kolar District. The study population included rural women aged 18 years and above. Cluster sampling technique was used for sample selection. All the 20 villages in the field practice area of PHC, Devarayasamudra were considered as clusters, and 6 such clusters were selected by Simple Random sampling. Villages were randomly selected using a random number generator. In each of the selected villages, I have allocated samples by probability proportional size accordingly to meet my estimated sample size of 511. Tobacco consumption was assessed by using the (GATS)Global Adult Tobacco Survey questionnaire. Results: Smokeless tobacco (SLT) use was reported by 70% of rural women in Kolar. The most frequently used items were khaini (47.9%), gutkha (68%), 15 pan/betel quid (63.8%), and betel quid with tobacco (23.19%). The use of SLT was found to be substantially connected with socioeconomic status, age, occupation, education, and family influence. Women with less education and those from poorer socioeconomic backgrounds were more likely to use SLT. Peer pressure and family history also had a substantial impact on tobacco use initiation and continuance. Conclusion: This study highlights the high incidence of smokeless tobacco use among rural women, which is influenced by a number of behavioural and socioeconomic factors. Significant relationships were identified between lower socioeconomic status, employment type, illiteracy, and cultural norms. Women who worked in physically demanding jobs including farming and daily wage labor were more likely to smoke due to habitual behaviour, peer pressure, and stress relief. Other important characteristics included age, education, and marital status; women who were older and less educated were more likely to use smokeless tobacco. The study also highlights the ways in which ignorance, social acceptance, and accessibility support tobacco use.