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Introduction: Cigarette smoking in English residents of Bangladeshi origin, particularly men, exceeds national estimates. Cessation outcomes and potential predictors of successful cigarette smoking cessation in this group await identification.Methods: This service review reports cessation outcomes and predictors of success for 324 adult English resident Bangladeshi origin smokers recruited into a project providing a specialist tobacco cessation service. Interview measures included sociodemographics, tobacco use and dependence. Cessation data (self-reported and validated) at 4 weeks was also collected. Cessation rate and predictors of successful cessation, modeled using multiple logistic regressions, are reported.Results: Clients' mean age was 45.59 (SD = 13.83) years. Thirty-three (10%) were females. Mean level of small area deprivation was 56.98 (SD = 5.37). Initial mean expired air carbon monoxide score was 11.66 parts per million (SD = 7.17). Thirty-eight per cent used combination nicotine replacement therapy (NRT) with behavioral support. Sixty-nine percent reported successful smoking cessation after 4 weeks, validated with carbon monoxide (mean =1.23 parts per million, SD = 1.32). Predictors of successful cessation were use of combined NRT with behavioral support (OR = 1.82, 95% CI = 1.07, 3.09), and community recruitment (OR = 1.85, 95% CI = 1.07, 3.22).Conclusions: English adult smokers of Bangladeshi origin resident in a highly disadvantaged locality, accessing community outreach services to help them quit and using NRT have validated short-term success rates greater than that locality's general population who access National Health Service Stop Smoking Services to quit. [ABSTRACT FROM AUTHOR]

Aim To evaluate smokeless tobacco cessation in communities of South Asian origin. Design Multi-centre prospective cohort study. Setting Three tobacco cessation services offering specialist smokeless tobacco cessation outreach clinic support to South Asians ( Bangladeshi, Indian and Pakistani) resident in England. Participants A total of 239 South Asian participants seeking to stop smokeless tobacco use between November 2010 and December 2011. Measurements Socio-demographics, tobacco use and dependence, self-reported abstinence at 4 weeks and satisfaction measures. Findings Participants' mean age was 45 [standard deviation ( SD) = 13] years, were predominantly female (76%), of Bangladeshi origin (74%), either home carers (53%) or not working (29%). Sixty-three per cent were recruited from community locations, 21% through a clinical contact and 16% through friends and family. Mean daily number of smokeless tobacco intakes was 10 ( SD = 7) and the mean dependence score was 4.5 ( SD = 1.9). Sixty-three per cent of participants achieved continuous abstinence 4 weeks after quitting. Using nicotine replacement therapy ( NRT) versus not using it [ OR = 3.47, 95% confidence interval ( CI): 1.25, 9.62] and below median (≤8) daily smokeless tobacco intakes ( OR = 1.91, 95% CI: 1.07, 3.40) predicted successful abstinence. Conclusion South Asian smokeless tobacco users resident in England accessing services to help them stop appear to have short-term success rates comparable with smokers attending stop-smoking services, with higher success rates being reported by those using nicotine replacement therapy. [ABSTRACT FROM AUTHOR]

Objective. To reflect on recent proposed tobacco control initiatives in the socio-cultural context of the smoking behaviours of UK resident Bangladeshi men. Design. Cross-sectional study using focus groups and one-to-one interviews conducted in English and Sylheti. Eighty-one men, aged 18-64 years, were recruited from the Bangladeshi community of Tower Hamlets, London, during 2002. Participants were purposively selected to reflect their age, place of birth and tobacco-use status. The discussions were tape-recorded and subsequently transcribed. The transcripts were analysed using 'framework' principles. Three of the current themes for tobacco control - smoke-free workplace environments, access to alternative sources of tobacco, and use and availability of nicotine replacement therapy - were used to organise the data. Results. Smoking initiation and use was confirmed as linked to gender, age, religion and tradition. Continued smoking was supported by anxieties about harassment in younger respondents, the migration experience of older respondents, and the unskilled employment opportunities available in the restaurant trade. These employment opportunities, whilst providing social support, did not support smoking regulations, in contrast to the practices observed in the general employment market. Levels of knowledge about the health risks of smoking varied by age. Three cheaper alternative tobacco types were readily accessible for use: contraband, roll-ups and traditional chewing tobacco in paan (chewing tobacco mixed with areca nut rolled in a betel leaf). Despite the latter's associations with use by women, younger respondents described the transition to chewing tobacco in paan as a smoking cessation aid instead of nicotine replacement therapy. There was confusion about the purpose, availability and efficacy of nicotine replacement therapy. Respondents reported isolation and marginalisation from current tobacco control initiatives, including much NHS Stop Smoking Service provision. Conclusion. The socio-cultural context of the smoking behaviours of this group of Bangladeshi men was linked to a reported isolation and exclusion from current tobacco control initiatives. These initiatives should be inclusive and address the reported needs of this community. The findings have implications for service development. Addressing these findings will help to inform the implementation of relevant public health policy initiatives for tobacco control to meet the needs of this community. [ABSTRACT FROM AUTHOR]

Objectives: To explore the self-reported oral health and health behaviours of a sample of Inner London Chinese elders and the impact of their self-reported oral health on their social functioning and eating ability.Design: Cross sectional.Setting: Luncheon clubs in Central and East London, UK.Subjects: 54 Chinese elders aged 54-81 years.Intervention: A structured questionnaire, administered by two interviewers in Cantonese.Main Outcome Measures: Knowledge and beliefs about the causes and prevention of tooth decay and gum disease, the oral conditions experienced in the previous twelve months and the impact of these conditions.Results: Overall health was rated more positively than oral health, although those who reported below average oral health were more likely to report below average overall health. Whilst over half thought that sugar and sweet food could cause tooth decay, only 19% thought that poor oral hygiene could cause gum disease. Over half thought that "hot air" caused gum disease. Three quarters brushed their teeth at least twice a day. Two thirds had experienced at least one oral condition in the previous twelve months, with the more elderly being more likely to report this. Social impacts affected 41% of the sample whilst 44% suffered at least one dietary impact.Conclusions: The burden of oral conditions is substantial, especially on the more elderly members, impacting on the performance of social functions. These burdens indicate a need for oral health services. Beliefs in the traditional Chinese explanation of "hot air" as a cause of gum disease were common. Health promotion effort should consider these when developing health messages. [ABSTRACT FROM AUTHOR]

BackgroundLittle is known of paan quid with tobacco (PQT), a hand-made mixture of smokeless tobacco, areca nut, lime and flavourings in a betel leaf, despite its wide use in south Asian communities. This study has explored the price, tobacco types, brands and ingredient weights in vendor assembled PQT in London (England).MethodsThis cross-sectional study identified 31 commercial outlets selling PQT. Outlet staff were invited to assemble PQT for purchase. Individual ingredients were identified and weighed using a calibrated scale. Free nicotine availability was assessed in the laboratory. The data were analysed using frequencies, means, t test and Pearson correlations. Significance was set at p<0.05.Results73 samples were assembled and purchased. Mean total PQT weight was 10.06 g (95% CI 9.26 to 10.86). Mean price was £1.43 (range £0.50–3.50), which varied by location (p=0.001). The most common smokeless tobacco type was zarda (64.4%). Mean tobacco weight was 0.65 g (95% CI 0.56 to 0.76) and the mean lime weight was 0.58 g (95% CI 0.41 to 0.75). While other ingredients did not vary, tobacco and lime mean weights varied by location (p=0.01). Tobacco and lime weights correlated positively (r=0.427, p=0.01). The pH of the tobacco and lime mix varied between 12.2 and 12.5, indicating 99% free nicotine availability.ConclusionsVendor assembled PQT shares similar ingredients but varies by assembly locality, price and tobacco and lime weights. Tobacco and lime weights were balanced to ensure optimal free nicotine availability and dependency potential. [ABSTRACT FROM AUTHOR]

Aim: This cross sectional study recruited adult male Yemeni residents in Sheffield and Birmingham, UK, to assess their use of khat., Methods: Structured interviews were conducted in both areas during weekly khat chewing sessions. The data collected included socio-demographic characteristics, khat use, dependency on khat, psychological functioning of chewers (GHQ-12) and nicotine dependency. Patterns of khat use, dependency and psychological functioning were correlated with age and self-reported oral problems., Results: 75 khat chewing volunteers (mean age 40.75 years) were interviewed. Average age of starting khat chewing was 17 years. The weekly amount chewed ranged from 0.25-3.0 khat bundles. Older respondents were more likely to be frequent chewers (p<0.025). 39% were assessed as dependent on khat, which correlated with frequency of use (p<0.041) and being in debt (p<0.046). Khat chewing correlated with nicotine dependence (p< 0.014). Self-reported oral problems correlated with both nicotine (p<0.04) and khat dependence (p<0.001). 93% reported that khat chewing promoted excessive smoking and 12% that this practice had initiated their tobacco use., Conclusions: Khat chewing creates dependency and correlates with tobacco smoking and nicotine dependence. Further research should investigate the correlations between khat and nicotine dependence. Development of a specific measure of khat dependence is recommended.