Search

INTRODUCTION Understanding the relationship between age at smoking initiation and later smoking intensity is crucial for assessing future health consequences of smoking early and informing strategies to prevent and reduce tobacco use. This study explores the relationship between the two smoking-related behaviors among Filipino daily smokers. METHODS Secondary data analyses from the 2021 Global Adult Tobacco Survey Philippines were performed. This study covers those who were reported to be daily smokers. The outcome of interest was smoking intensity, measured as the number of manufactured cigarettes consumed per day, while the main predictor was age at smoking initiation. Data from 2260 participants were analyzed. Negative binomial regression was used to test for the relationship between age at smoking initiation and smoking intensity while controlling for sociodemographic variables and other smoking-related behaviors. RESULTS The average age at which daily smoking commenced was 20.93 (SD=6.35) years, while the average number of manufactured cigarettes consumed per day was 9.50 (SD=7.26). Age at smoking initiation was a significant predictor of smoking intensity, even after controlling for potential confounders. Each additional year in the age at which smoking was initiated was associated with a 1.55% decrease in smoking intensity in the adjusted model (ß= -0.0155, p<0.0001). Other predictors of smoking intensity were current age (ß=0.0072; 95% CI: 0.0050-0.0094, p<0.0001), sex (ß= -0.1146; 95% CI: -0.2157 - -0.0136, p=0.0262), and smoking rules at home (ß=0.1807; 95% CI: 0.1175-0.2439, p<0.0001). CONCLUSIONS Greater smoking intensity may be linked to early smoking initiation among Filipino adult daily smokers. The results may support interventions that target younger ages to curb heavy tobacco use at later ages. [ABSTRACT FROM AUTHOR]

This study examines the prevalence of and factors associated with "hardcore" use of smoked and smokeless tobacco (SLT) products in Bangladesh and the variation in the ages people started using them daily. Data from the 2009 and 2017 rounds of the Global Adult Tobacco Survey for Bangladesh were analyzed using multilevel logistic regression. The prevalence of "hardcore" use of smoked tobacco among current smokers decreased from 15.5% in 2009 to 13.1% in 2017. Almost all hardcore smokers were male in both rounds. Among the current users of SLT, 7.0% were "hardcore" users in 2009, with a higher proportion of females (8.9%) than males (4.8%) and these percentages remained similar in 2017. The current smokers in the age-group 25-64 and the current SLT users in the age-group 45-65+ were more likely than their counterparts to be "hardcore" users. The earlier the participants started using daily, the more likely they were to become "hardcore" users. There was regional variation in the prevalence of "hardcore" use. Coordinated preventive interventions and comprehensive treatment programmes and their equitable geographical distribution are needed. [ABSTRACT FROM AUTHOR]

This study estimates the prevalence of daily dual users (DDUs) (i.e., used both smoked and smokeless tobacco (SLT) daily) of tobacco in Bangladesh and identifies associated factors ; examines approaches they used to quit tobacco use and identifies past attempts and future intention to quit. Data of current tobacco users (n=9,370) collected in two rounds of the Global Adult Tobacco Survey were analyzed. Logistic regressions were used to identify factors associated with DDUs, and Poisson regressions to identify DDUs' previous attempts and future intentions to quit. Among the current users, the prevalence of DDUs decreased from 10.7% in 2009 to 6.4% in 2017. Almost half of the DDUs tried to quit smoking and a quarter to quit SLT during 12-month before the survey. DDUs were more likely than non-DDUs to make a quit attempt (adjusted prevalence ratio (aPR):1.28, 95%Confidence interval (95%CI):1.09–1.50) and intend to quit in the future (aPR:1.13, 95%CI:1.03–2.25). Most of those who attempted to quit received no cessation treatment, and some started using SLT. The prevalence of DDUs decreased recently. DDUs were more likely than non-DDUs to report past attempts and future intentions to quit. Cessation treatments should be made available and affordable to expedite tobacco control measures. [ABSTRACT FROM AUTHOR]

Youths are exposed to multiple sources of tobacco advertisements. We sought to examine patterns of exposure to smoked tobacco advertisements through various modes among Indian youths and its association with smoked tobacco use. Cross-sectional survey design. We utilised data from the national Global Adult Tobacco Survey 2016–17 in India, which covered adults >15 years of age. Latent Class Analysis (LCA) was used to examine patterns of exposure to tobacco advertisements through various modes (television, radio, cinema, internet, posters, billboards, public transportation, public walls, stores, newspaper) among youths. Classes were compared across sociodemographic and tobacco use–related characteristics. Various model-fit statistics (Akaike, Bayesian and sample size–adjusted Bayesian Information Criteria, likelihood-ratio tests and, Entropy) and meaningfulness of the classes were used to select the number of latent classes. Three distinct latent classes were identified in terms of exposure to smoked tobacco products advertisements: "Multimodal exposure" (n = 448, 4.0%), "low exposure" (n = 9584, 86.0%), and "Television and stores" (n = 1116, 10.0%). There were significant differences between classes emerged on sociodemographics (age, sex, residence, education, wealth quintile, region). The "Multimodal exposure" class was associated with current tobacco smoking (odds ratio [OR]: 2.0, 95% confidence interval [CI]: 1.4–3.0, P -value <0.001) and cigarette use (OR: 1.9, 95% CI: 1.3–3.4, P -value <0.001) compared to the "low exposure" class. Youths could be grouped into three classes based on their exposure to smoked tobacco product advertisements. The "Multimodal exposure" class with a distinct profile was significantly associated with smoked tobacco use among youths. This evidence supports complete ban on all forms of tobacco advertisements. [ABSTRACT FROM AUTHOR]

Background: Tobacco is a commonly used addictive substance which is one of the leading causes of morbidity and mortality worldwide. In India, tobacco is used in the form of smoking and smokeless tobacco. The diverse demographics of tobacco use, monitoring, raising awareness, and control policies are effective in halting the tobacco epidemic. In order to obtain these various data, the present study was undertaken with an aim to assess tobacco use among the people of Kurnool, India. Materials and Methods: A cross-sectional study was conducted which was a household interview-based survey. The study consists of demographic details such as age, education, occupation, and Global Adult Tobacco Survey questionnaire which consist of 20 questions on the usage and type of smoke and smokeless tobacco, second-hand smoke, cessation, anti-cigarette advertising, and economics. A total sample of 950 participants were included which was collected through cluster sampling method in Kurnool district. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 24. Descriptive statistics including frequency and percentages were calculated. Results: The study comprised 656 (69.1%) males and 294 (30.9%) females. The prevalence of tobacco smokers and smokeless tobacco were 163 (17.2%) and 46 (4.8%), respectively. A greater percentage of subjects who smoke inside the home daily and weekly were observed among male subjects and 15–30 years of age group. Conclusion: The prevalence was high among tobacco smokers compared to smokeless tobacco users. Furthermore, tobacco usage in the form of smoking and smokeless tobacco, which made quit attempt were observed more among male subjects, 41–50 years of age group, illiterates, and unskilled workers.

Background: Tobacco is a commonly used addictive substance which is one of the leading causes of morbidity and mortality worldwide. In India, tobacco is used in the form of smoking and smokeless tobacco. The diverse demographics of tobacco use, monitoring, raising awareness, and control policies are effective in halting the tobacco epidemic. In order to obtain these various data, the present study was undertaken with an aim to assess tobacco use among the people of Kurnool, India. Materials and Methods: A cross-sectional study was conducted which was a household interview-based survey. The study consists of demographic details such as age, education, occupation, and Global Adult Tobacco Survey questionnaire which consist of 20 questions on the usage and type of smoke and smokeless tobacco, second-hand smoke, cessation, anti-cigarette advertising, and economics. A total sample of 950 participants were included which was collected through cluster sampling method in Kurnool district. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 24. Descriptive statistics including frequency and percentages were calculated. Results: The study comprised 656 (69.1%) males and 294 (30.9%) females. The prevalence of tobacco smokers and smokeless tobacco were 163 (17.2%) and 46 (4.8%), respectively. A greater percentage of subjects who smoke inside the home daily and weekly were observed among male subjects and 15--30 years of age group. Conclusion: The prevalence was high among tobacco smokers compared to smokeless tobacco users. Furthermore, tobacco usage in the form of smoking and smokeless tobacco, which made quit attempt were observed more among male subjects, 41--50 years of age group, illiterates, and unskilled workers. [ABSTRACT FROM AUTHOR]

The aims of the study were to identify latent classes of adult tobacco or nicotine-based product users in India, compare their sociodemographic distribution and quitting behaviour and explore the association of quitting behaviour and time to first tobacco use with class membership. This was a nationally representative cross-sectional survey. Data from the Global Adult Tobacco Survey 2016–2017 in India, which covered adults aged >15 years, were analysed. Latent class analysis was used to examine patterns of tobacco or nicotine-based product use (cigarette, bidi, cigar, e-cigarette, chewable tobacco and snuff) among current tobacco users. Classes were compared across sociodemographic and tobacco use–related characteristics. Various model fit statistics (Akaike, Bayesian and Sample Size–Adjusted Bayesian Information Criteria, Likelihood Ratio Tests and Entropy) and meaningfulness of the classes were used to select the number of latent classes. Of 21,857 current tobacco users , five latent classes were extracted: 'poly-tobacco use' (103, 0.5%), 'oral chewable products predominantly' (11,306, 51.7%), 'bidi predominantly' (4965, 22.7%), 'cigarette predominantly' (5318, 24.3%) and 'snuff and chewable products' (165, 0.8%). Significant differences between classes emerged on sociodemographics (age, sex, residence, education, wealth quintile, region). 'Bidi predominantly' class was associated with higher likelihood of quit attempts. Compared with 'cigarette predominantly' class, other classes were significantly associated with time to first tobacco use. We found that people in India could be grouped into five classes based on their tobacco or nicotine-based product use pattern. It may be efficient to tailor messages to different latent classes and address the distinct profiles of these groups of tobacco product users. [ABSTRACT FROM AUTHOR]

Abstract Background Smoking inequalities in Turkey were previously demonstrated in an early stage of the smoking epidemic model. This paper aimed to assess the trends for socioeconomic inequalities in smoking in Turkey over the years in the context of the smoking epidemic model using data from the Global Adult Tobacco Survey (GATS) Turkey 2008–2012-2016. Methods Cross-sectional data were analyzed to calculate the association of smoking with, wealth, education, occupation and place of residence using age-standardized prevalence rates, odds ratios, relative index of inequality (RII) and slope index of inequality (SII). The analysis was performed separately for age groups (younger: 20–39 years/older: 40 and above years) and sex. Results Younger women with higher wealth and older women with higher wealth and education smoked more. For both age groups, smoking was increased for working class and urban women. Relative wealth inequalities in smoking narrowed and then showed a reversal for younger women (RII2008 = 3.37; 95% CI:1.64–3.40; RII2012 = 2.19; 95% CI:1.48–3.24; RII2016 = 0.80; 95% CI:0.58–1.10, p-for trend

Background: Hardcore smokers are of significant public health concern having a greater risk of developing tobacco-related diseases. Objective: This study aimed to identify burden of hardcore smokers, its distribution, and determinants in India. Subjects and Methods: Analysis of Global Adult Tobacco Survey India 2016–2017 data was carried out. Hardcore smoking was defined when the following criteria were fulfilled – current daily cigarette smoking for at least 5 years, no quit attempt in past 12 months, no intention to quit in next 12 months, and time to first smoke within 30 min of waking up. Independent variables included sociodemographic, knowledge of side effects, indoor smoking policy, and age of smoking initiation. Multivariable logistic regression was carried out, with adjustment for clustering, stratification, and sampling weight. Results: Proportion of hardcore smoking among the general population and current daily smokers were 3.43% and 32.3%, respectively. In the adjusted model, it was found to be significantly associated with increasing age, earlier initiation of daily smoking, tribal caste, and unfavorable indoor smoking policy. Conclusion: Tobacco control strategies should be modified to tackle these issues, especially early age of initiation of daily smoking and indoor smoking policy.

Introduction: Health warning labels (HWLs) are one of the key strategies for tobacco control. The current study assessed the individual characteristics affecting the noticeability of HWLs and the thought of quitting smokeless tobacco (SLT) on noticing HWLs. We further estimated the temporal changes in noticeability and thought of quitting after noticing HWLs over time in India., Methods: Data from two rounds (2009-2010 and 2016-2017) of GATS (Global Adult Tobacco Survey) from India were analysed to understand the pattern of SLT usage and estimate the relative changes in the noticeability of HWLs and the thought of quitting SLT among those who noticed HWLs. Sampling weights were used during the analysis. Multivariate binary logistic regression was used to explore the determinants for the noticeability of HWLs and encourage the intention to quit SLT after noticing the HWLs., Results: About 25.9% and 20.6% of participants consumed SLT daily or non-daily in two rounds of GATS. Overall, there was a 14% relative increase in noticing the HWLs and a 20% increase in the thought of quitting in GATS-2 compared with GATS-1. The adjusted odds ratio of observing HWLs among SLT users was 1.51 times (95% confidence interval (CI), 1.44-1.58) in round 2 compared with round 1, while the odds ratio concerning the thought of quitting SLT after noticing HWLs was 1.95 times (95% CI, 1.84-2.06) in round 2 compared with round 1., Conclusions: We observe a consistent increase in the noticeability of HWLs and intentions to quit in SLT users, with significant variations across socio-demographic characteristics calling for concerted efforts. SLT being the major form of tobacco usage in India and Asian countries, HWLs alone cannot bring down the consumption rates, and it needs to be supported by strict implementation of SLT legislation for long-lasting impact., Competing Interests: Declaration of conflicting interestsThe authors have no conflicts of interest to declare.

Background: Smoking inequalities in Turkey were previously demonstrated in an early stage of the smoking epidemic model. This paper aimed to assess the trends for socioeconomic inequalities in smoking in Turkey over the years in the context of the smoking epidemic model using data from the Global Adult Tobacco Survey (GATS) Turkey 2008-2012-2016.Methods: Cross-sectional data were analyzed to calculate the association of smoking with, wealth, education, occupation and place of residence using age-standardized prevalence rates, odds ratios, relative index of inequality (RII) and slope index of inequality (SII). The analysis was performed separately for age groups (younger: 20-39 years/older: 40 and above years) and sex.Results: Younger women with higher wealth and older women with higher wealth and education smoked more. For both age groups, smoking was increased for working class and urban women. Relative wealth inequalities in smoking narrowed and then showed a reversal for younger women (RII2008 = 3.37; 95% CI:1.64-3.40; RII2012 = 2.19; 95% CI:1.48-3.24; RII2016 = 0.80; 95% CI:0.58-1.10, p-for trend < 0.0001). Relative educational inequalities in smoking for older women also showed a narrowing (RII2008 = 21.45; 95% CI:11.74-39.19; RII2012 = 15.25; 95% CI:9.10-25.55; and RII2016 = 5.48; 95% CI:3.86-7.78, p-for trend < 0.0001). For older women, a similar narrowing was observed for wealth (RII2008 = 3.94; 95% CI:2.38-6.53; RII2012 = 2.79; 95% CI:1.80-4.32; and RII2016 = 1.34; 95% CI:0.94-1.91, p-for trend = 0.0001). The only significant trend for absolute inequalities was for younger women by wealth. This trend showed a narrowing and then a reversal (SII2008 = 0.14; 95% CI:0.09-1.20; SII2012 = 0.12; 95% CI:0.06-0.18; and SII2016 = -0.05; 95% CI:-0.12-0.02, p-for trend = 0.0001). Unlike women, smoking in men showed inverse associations for wealth and education, although not statistically confirmed for all years. Smoking was increased in working classes and unemployed men in 2012 and 2016. Inequalities did not show a trend in relative and absolute terms for men.Conclusions: For smoking inequalities in Turkey, a transition to the next stage was observed, although the previously defined Southern European pattern also existed. Low socioeconomic women deserve special attention as well as stressors at work and drivers of smoking at urban settings. [ABSTRACT FROM AUTHOR]

Background: Hardcore smokers are of significant public health concern having a greater risk of developing tobacco-related diseases. Objective: This study aimed to identify burden of hardcore smokers, its distribution, and determinants in India. Subjects and Methods: Analysis of Global Adult Tobacco Survey India 2016-2017 data was carried out. Hardcore smoking was defined when the following criteria were fulfilled -- current daily cigarette smoking for at least 5 years, no quit attempt in past 12 months, no intention to quit in next 12 months, and time to first smoke within 30 min of waking up. Independent variables included sociodemographic, knowledge of side effects, indoor smoking policy, and age of smoking initiation. Multivariable logistic regression was carried out, with adjustment for clustering, stratification, and sampling weight. Results: Proportion of hardcore smoking among the general population and current daily smokers were 3.43% and 32.3%, respectively. In the adjusted model, it was found to be significantly associated with increasing age, earlier initiation of daily smoking, tribal caste, and unfavorable indoor smoking policy. Conclusion: Tobacco control strategies should be modified to tackle these issues, especially early age of initiation of daily smoking and indoor smoking policy. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The present study aimed to determine the prevalence, patterns and contributing factors for tobacco usage amongst Saudi population. MATERIALS AND METHODS: Between April and June 2013, a cross-sectional study was organized among 10735 individuals aged 15 years or older. The survey consisted of face-face interview for collecting data on socio-demographics, tobacco usage, diet, physical activity and comorbidities. Univariate and multivariate binary logistic regression was applied to check for the association of prevalence (both smoked and smokeless) with socio-demographic factors. The strength of association was examined by approximating odds ratios (OR) with their 95% CI using SPSS software and p-value set at < 0.05. RESULTS: A total of 10195 respondents aged from 15 to 101 were considered. Overall prevalence of current smoking was 12.8%. Daily smoking was reported by 12% of the population. Sex, age group, education, married and occupation were strong predictors of tobacco use in both univariate and multivariable model. From multivariable model, men were 14.54 times more likely to smoke tobacco (aOR 14.54, 95% CI 11.07-19.11) when compared with women. Respondents between 15 to 30 years, 31 to 45 years, were 3.36 times (aOR 3.36, 95% CI 2.29- 4.93) and 3.51 times (aOR 3.51, 95% CI 2.47-4.98) more likely to smoke tobacco when compared to >60 years. CONCLUSIONS: The results of present study indicate a significant, but differing purpose of sex, age group, education, marital status and work status on tobacco usage in the country. [ABSTRACT FROM AUTHOR]

India enacted a smoke-free law in 2003. It is believed that smoke-free workplaces will lead to more smoking in private places such as homes. The national Global Adult Tobacco Survey (GATS 2) India 2016–2017 collects information on the self-reported prevalence of SHS exposure in homes and workplaces. The present study utilised the GATS 2 dataset to establish the association between working in a smoke-free workplace and living in a smoke-free home. 70.1% of respondents who worked indoors reported smoke-free workplace; 64.5% of respondents reported that they live in a smoke-free home. Respondents who reported that their workplace was smoke-free were significantly more likely to live in smoke-free homes compared with those who are exposed to SHS at the workplace (69.5% vs 45.5%, AOR = 1.8, 95% CI 1.5–2.1). Males, urban residents, family with fewer members, non-smokers and non-smokeless tobacco users were significantly more likely to live in a smoke-free home. Significant differences were also observed with respect to religion, caste, region and education levels. Our results provide conclusive evidence to support that smoke-free workplaces influence smoke-free homes in India. Thus, it highlights the importance of accelerating the implementation of existing national tobacco control legislation on smoke-free public places. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco use is a leading cause of death and disability worldwide, particularly in South-East Asia. The tobacco problem in India is probably more complex than in any other country, with a huge consequential burden of tobacco related diseases and deaths. The present study aimed at analyzing the pattern and predictors of tobacco use among college students aged 18-24 years, using the Global Tobacco Surveillance System (GTSS). METHODS A cross-sectional study was conducted among 2063 students, from 30 colleges of Mangalore, South India, who were selected by multistage sampling with probability proportional to size. The tobacco questions used for this study were a validated, recommended subset of key questions from the Global Adult Tobacco Survey (GATS). Data analysis was performed using GATS manuals and SPSS version 24.0. RESULTS A total of 2063 students participated in the study (738 males, 1325 females). Prevalence of tobacco smoking was 4.8%, which included 9.9% males and 2.1% females. Manufactured cigarettes were the most commonly preferred tobacco product among daily smokers. The overall percentage of smokeless tobacco use was 4.8%, which included 7.4% males and 3.3% females. Logistic regression analysis showed that 71.4% of the participants who noticed anticigarette information on television made an attempt to quit smoking. The odds ratio (OR) of quitting was 4.4 times higher compared to those who did not notice any information on television (p=0.002). In addition, noticing health warnings on cigarette packs strongly influenced an individual to quit smoking (OR=30.09). CONCLUSIONS The study results showed low prevalence of the use of both smoked and smokeless forms of tobacco, current smoking, and chewing tobacco, among the study population. Generating data in this part of the country on tobacco use and developing tobacco control measures at regular intervals are essential to better understand and develop effective intervention programs. [ABSTRACT FROM AUTHOR]

Background: Second-hand smoke (SHS) has enormous adverse health impacts with grave health implications for the next generation. Section 4 of Indian legislation, Cigarettes and Other Tobacco Products Act, prohibits smoking at public places, thus protecting people from SHS. Objective: The objective of present study was to assess the exposure to SHS at home and working areas in Punjab, India. Methods: The present cross-sectional study was conducted from December 2015 to March 2016. A three-stage sampling technique was used for collecting data from three randomly selected districts representing three major regions of Punjab, India. A sample size of 510 individuals was divided equally into an urban and rural area with proportionate sampling on the basis of subsets of age groups and gender. The questionnaire based on tobacco questions for the survey, a subset of key questions from global adult tobacco survey was used. Results: At home, the odds of exposure to SHS exposure was higher (odds ratio [OR] = 2.2, 95% confidence interval [CI] = 0.6–7.3) in urban area, females, low educational status, and nongovernment employee as compared to their counterparts. At workplace, (OR = 3.9 and 95% CI = 1.11–14.3) SHS exposure was higher in rural area, among males, primary and middle education and nongovernment or self-employed occupation. Conclusion: SHS exposure was low in Punjab, India especially in females as compared to other states of the country. The socio-economic disadvantaged groups and people with low education were more likely to experience exposure to SHS at workplace, which should be targeted to reduce tobacco consumption.

Introduction: Till 2016, India was the second largest consumer of tobacco in the world, second only to China. However, in June 2017, the factsheet release of Global Adult Tobacco Survey-2 showed a 6% point decline in the prevalence of tobacco use among adults (>15 years) in the country. Materials and Methods: This is a form of ecological study where trends in aggregate prevalence of tobacco use at country level (using secondary data) were studied in relation to corresponding policy actions over a period of two decades. Results: The results have shown that initial policy actions since the cigarettes act of 1975 till prevention of food adulteration Amendment act of 1995 were largely targeting cigarettes, and so smoking prevalence among men was constantly declining. On the other hand, smokeless tobacco use was increasing among both men and women and reached a peak in 2009–2010. After that, the government took strict policy actions including Food Safety and Standards Authority of India Gutka ban in 2011. There were other persistent efforts, which are discussed in this paper. As a result, a transition has occurred in relation to tobacco epidemic in India. Conclusion: The paper has been concluded with a note that there is no room for complacence and we have a noncommunicable disease action goal to further decline the prevalence of tobacco use in the country to

Objective To identify the relationship of quit intention of smoking among daily smokers in Vietnam. Methods Data are subtracted from dataset of Global Adult Tobacco Survey (GATS) of 2010 and 2015 of the Global Tobacco Surveillance System (GTSS). Households were sampled using a stratified multistage design. All men who are currently smoking daily are selected for final analysis. Quit intention of smoking defines as dependent variable. Knowledge, attitude, practice toward smoking; Heaviness of Smoking Index; Demography define as independent variables. Multivariate logistics model was used. Results The proportion of smokers are interested in quitting smoking following: planning to quit within next month (6.2%); thinking about quitting within the next 12 months (15.5%); and will quit someday, but not the next 12 months (38.5%). High education, good attitude of harming of smoking on health were positively associated with intentions to quit smoking with adjusted odd ratio: 1.70 (1.04-2.75); 1.89 (1.19-2.98), respectively. Reversely, Heaviness of Smoking Index (HIS) with moderate smoking, less supported for taxes rise on tobacco products were negatively associated with intentions to quit smoking with adjusted odd ratio: 0.66 (0.51-0.83); 0.72 (0.56-0.92), respectively. Conclusions The finding implies that identifying the determinants of quit intentions provides practical evidence for shaping effective policies and programs for advancing quitting among smokers in Vietnam.

Background: The Global Adult Tobacco Survey (GATS) is a global study to monitor tobacco use, and evaluate current measures and requisite policies on tobacco control. In this study, the key indicators from GATS Kazakhstan that address six tobacco control policies are assessed. Methods: GATS Kazakhstan was a nationally representative household survey of the adult population aged 15 yr or older (n=4425, 52.8% females) implemented in 2014, in all regions of Kazakhstan. A multi-stage, geographically clustered sample design was used to obtain the key indicators of tobacco use and tobacco measures in the country. The sampling weights were employed to ensure real national representation. A household and individual questionnaire were administered through electronic devices. Results: The majority of current tobacco users were cigarette smokers 22.2%. Overall, 19.0% of adults were exposed to secondhand smoke while at work. One third of smokers made a quit attempt in the last 12 months. Only, 74.0% of adults believed that breathing other people’s smoke causes serious illness in non-smokers. Almost all current smokers (97.6%) noticed pictorial health warnings on cigarette packages. Over half (58.0%) of the current smokers had thought about quitting, having seen pictorial warning labels. Exposure to any cigarette advertisement, sponsorship or promotion had been experienced by 25.7% of adults, with the highest rate of noticing cigarette advertisements being found in stores where cigarettes are sold (14.0%). Cigarettes were largely affordable for the population. Conclusion: The GATS Kazakhstan results identified tobacco use indicators, as well as existing gaps in tobacco control measures.

Kazakhstan is one of the countries with higher-than-average smoking prevalence and tobacco-related mortality. Intention to quit is a key step toward smoking cessation, yet has not been studied in Kazakhstan. This study explored prevalence and correlates of intention to quit among smokers in Kazakhstan. We drew data from the nationally representative survey, the Global Adult Tobacco Survey (GATS), conducted during 2014 in Kazakhstan. Our sample consisted of 649 smokers aged =15 years. We examined prevalence of intention to quit by demographics, knowledge of tobacco-related diseases, nicotine dependence, attempt to quit in the past 12 months, household smoking restrictions, and awareness of antismoking messages. Univariate and multivariate logistic regressions were used to test the significance of these correlates. Prevalence of intention to quit was around 75.9% among smokers. Older age (p < 0.001), knowledge of tobacco-related diseases (p < 0.01), moderate nicotine dependence (p < 0.001), attempt to quit within the past 12 months (p < 0.001), and having household smoking restrictions (p < 0.001) were all significant correlates. We suggest investing in efforts to promote cessation activities for smokers of all ages, to disseminate comprehensive information on tobacco-related diseases, and to uphold and strengthen policies on smoking bans.

Secondhand smoke (SHS) accounts for 0.9 million deaths and 24 million disability adjusted life years (DALYs) annually. Nearly 30% of adults in India are exposed to SHS in India. To reduce SHS exposure, India enacted a smoke-free law in 2003 under which smoking in public places is banned. However, the compliance to this law has been variable in several assessments in the country. A better understanding of the nature and extent of SHS exposure can help inform better implementation of national smoke-free policies. The Global Adult Tobacco Survey (GATS) India 2016–17 collects information on the self-reported prevalence of SHS exposure in homes, workplaces, government buildings, restaurants, public transportation and health care facilities among adults (> 15 years of age).The present study utilized the GATS India 2016–17 dataset to provide estimates of SHS exposure among adults in India in homes, workplace and other public places, across gender and age groups and among the overall population and non-smokers. Weighted analysis was carried out. In the overall population, exposure to SHS in the home was 29.2%, more among young females. In workplaces, exposure to SHS was 29.2% overall, significantly higher among males (32.5%) compared to females (17.8%). In public buildings such as health care facilities and government offices, SHS exposure was less with 15.6% and 21.2% respectively. SHS exposure was high in restaurants with 39.3% overall, significantly higher among males (43.2%) compared to females (22.2%). Similar results were also seen among non-smokers. A large proportion of adults in India, both smokers and non-smokers are exposed to SHS in their homes, workplaces and other public places, especially restaurants, workplaces and public transportation. Females are more exposed to SHS at home, whereas males are more exposed in public places including workplaces. High SHS exposure among youths is also a concern. Stricter enforcement of legislation is required to ensure 100% smoke-free homes, public places and workplaces and reduce SHS exposure. [ABSTRACT FROM AUTHOR]

The consequences of tobacco consumption include disease and death. Many people want to give up tobacco use because of its dangers, but its addictive quality makes it difficult. The aim of this study was to detect the risk factors in Turkey that affect the number of days without tobacco consumption among individuals attempting to quit smoking in the last 12 months. Data collected from 1,251 individuals selected in the Global Adult Tobacco Survey were utilized in this study. The multivariate cox regression analysis was used to determine the factors that affected the number of days without tobacco among individuals aged 15 and above in Turkey. At the end of the analysis, variables, such as gender, education, age, household rules about tobacco consumption, supporting higher taxes for tobacco products, and household welfare indicators, were effective in the tobacco-free period. To prevent smoking relapses, tobacco cessation programs should be promoted among the citizens. Awareness of the risks associated with tobacco consumption should be raised and social support from family and friends to quit smoking should be further accentuated. [ABSTRACT FROM AUTHOR]

Background. Vietnam was one of 16 countries that implemented the second round of the GATS (Global Adult Tobacco Survey) in 2015. Aims. To assess knowledge and determinants of health consequences of different types of cigarette smoking among Vietnamese adults. Methods. A cross-sectional study among adults aged 15 years combined with using 15% of the master sample from the national sampling frame of the population and housing census was conducted. Multilevel analysis using Poisson regression was undertaken. Results. Knowledge on the health consequences of cigarette smoking has not significantly improved in the GATS-2015. Adults believe that active smoking had more of an impact on health than secondhand smoking and 24.5% and 43% of them answered that smoking light and e-cigarettes, respectively, causes less harm than regular cigarettes, and 17.3% and 18.1% of adults are not aware of the difference between them, respectively. Conclusion. Household and community's role had little impact in the adult knowledge of smoking health consequences. It is necessary to disseminate information on the "other tobacco product" and to improve public knowledge on specific health consequences, to enhance household and community's role in conveying health education messages to individuals. [ABSTRACT FROM AUTHOR]

Kazakhstan is one of the countries with higher-than-average smoking prevalence and tobacco-related mortality. Intention to quit is a key step toward smoking cessation, yet has not been studied in Kazakhstan. This study explored prevalence and correlates of intention to quit among smokers in Kazakhstan. We drew data from the nationally representative survey, the Global Adult Tobacco Survey (GATS), conducted during 2014 in Kazakhstan. Our sample consisted of 649 smokers aged ≥15 years. We examined prevalence of intention to quit by demographics, knowledge of tobacco-related diseases, nicotine dependence, attempt to quit in the past 12 months, household smoking restrictions, and awareness of antismoking messages. Univariate and multivariate logistic regressions were used to test the significance of these correlates. Prevalence of intention to quit was around 75.9% among smokers. Older age (p < 0.001), knowledge of tobacco-related diseases (p < 0.01), moderate nicotine dependence (p < 0.001), attempt to quit within the past 12 months (p < 0.001), and having household smoking restrictions (p < 0.001) were all significant correlates. We suggest investing in efforts to promote cessation activities for smokers of all ages, to disseminate comprehensive information on tobacco-related diseases, and to uphold and strengthen policies on smoking bans. [ABSTRACT FROM AUTHOR]

Context: Raising tax on tobacco products is one of the key tobacco control strategies. Globally, it has led to decrease in overall cigarette consumption but on the other hand contributed to increased sale and purchase of loose cigarettes. These loose cigarettes have many important public health implications. Aim: To assess the association between practice of buying loose cigarettes and intensity of smoking. Materials and Methods: A secondary analysis of Global Adult Tobacco Survey, India 2009–2010 data was performed in May 2014, on adult population age 15 years and above. The key outcome variable was “intensity of smoking” defined as average number of cigarettes smoked per day, whereas the key exposure variable was “practice of purchasing loose cigarettes.” Descriptive statistical analysis was performed using EpiData software (version 2.2.2.182) and STATA version 12.1. Results: Nearly, 57% of current cigarette smokers (approximately 3.46 million) bought loose cigarettes. The proportion of buying loose cigarettes decreased with increasing level of education and wealth index as well as least among government employees. The intensity of smoking was 70% less among loose cigarette buyers than nonbuyers (odds ratio [OR]: 0.29, 95% confidence interval [CI]: 0.24–0.34). It was found to be significantly lower in rural areas (OR: 0.81, 95% CI: 0.68–0.97) and among homemakers and those who had formal schooling. Conclusion: This study showed that loose cigarette buying is associated with decreased in smoking intensity. This may be due to increased taxes leading to increased buying of single cigarettes. These findings, therefore, highlight a need for a comprehensive policy and further studies on loose cigarette selling.

Viet Nam is among the countries having highest rate of male smokers in the world. The country has joined the Global Tobacco Surveillance System since 2010. Under this system, two rounds of Global Adult Tobacco Survey (GATS) were conducted in 2010 and 2015. Those two surveys provide excellent comparable data on tobacco usage and its related aspects in Vietnam. This study using the data from GATS 2015 to examine the salience and impact of cigarette pack health warnings on quitting intention in Vietnam. The Vietnam GATS 2015 was a nationally representative survey in which 9,513 households were selected using two-stage random systematic sampling method. Results of multivariate analysis showed that the strongest predictor for quit intention because of health warnings was "ever made a quit attempt in the past 12 months" followed by "believes that tobacco smoking causes serious illness". Compared to GATS 2010, GATS 2015 observed the increase in salience of cigarette health warnings. However, the current pictorial health warnings are losing their impact on motivating intention to quit. The results highlight that it is time to start the rotation cycle to refresh the current health warning set. Actions to select a new and more impressive set of pictorial health warnings should be developed as soon as possible. [ABSTRACT FROM AUTHOR]

Introduction: Till 2016, India was the second largest consumer of tobacco in the world, second only to China. However, in June 2017, the factsheet release of Global Adult Tobacco Survey-2 showed a 6% point decline in the prevalence of tobacco use among adults (>15 years) in the country. Materials and Methods: This is a form of ecological study where trends in aggregate prevalence of tobacco use at country level (using secondary data) were studied in relation to corresponding policy actions over a period of two decades. Results: The results have shown that initial policy actions since the cigarettes act of 1975 till prevention of food adulteration Amendment act of 1995 were largely targeting cigarettes, and so smoking prevalence among men was constantly declining. On the other hand, smokeless tobacco use was increasing among both men and women and reached a peak in 2009--2010. After that, the government took strict policy actions including Food Safety and Standards Authority of India Gutka ban in 2011. There were other persistent efforts, which are discussed in this paper. As a result, a transition has occurred in relation to tobacco epidemic in India. Conclusion: The paper has been concluded with a note that there is no room for complacence and we have a noncommunicable disease action goal to further decline the prevalence of tobacco use in the country to <24.22% by the year 2025. [ABSTRACT FROM AUTHOR]

Background: A large state-wide tobacco survey was conducted using modified version of pretested, globally validated Global Adult Tobacco Survey (GATS) questionnaire in 2015–22016 in Tamil Nadu, India. Due to resource constrains, data collection was carrid out using paper-based questionnaires (unlike the GATS-India, 2009–2010, which used hand-held computer devices) while data entry was done using open access tools. The objective of this paper is to describe the process of data entry and assess its quality assurance and efficiency. Methods: In EpiData language, a variable is referred to as ‘field’ and a questionnaire (set of fields) as ‘record’. EpiData software was used for double data entry with adequate checks followed by validation. Teamviewer was used for remote training and trouble shooting. The EpiData databases (one each for each district and each zone in Chennai city) were housed in shared Dropbox folders, which enabled secure sharing of files and automatic back-up. Each database for a district/zone had separate file for data entry of household level and individual level questionnaire. Results: Of 32,945 households, there were 111,363 individuals aged ≥15 years. The average proportion of records with data entry errors for a district/zone in household level and individual level file was 4% and 24%, respectively. These are the errors that would have gone unnoticed if single entry was used. The median (inter-quartile range) time taken for double data entry for a single household level and individual level questionnaire was 30 (24, 40) s and 86 (64, 126) s, respectively. Conclusion: Efficient and quality-assured near-real-time data entry in a large sub-national tobacco survey was performed using innovative, resource-efficient use of open access tools.

Background: Although substantial efforts have been made to curtail smoking in Vietnam, the 2010 Global Adult Tobacco Survey (GATS) revealed that the proportion of male adults currently smoking remains high at 47.4%. Objectives: To determine the level of, and characteristics associated with, knowledge of the health consequences of smoking among Vietnamese adults. Design: GATS 2010 was designed to survey a nationally representative sample of Vietnamese men and women aged 15 and older drawn from 11,142 households using a two-stage sampling design. Descriptive statistics were calculated and multivariate logistic regression was used to examine associations between postulated exposure factors (age, education, access to information, ethnic group etc.) and knowledge on health risks. Results: General knowledge on the health risks of active smoking (AS) and exposure to second hand smoke (SHS) was good (90% and 83%, respectively). However, knowledge on specific diseases related to tobacco smoking (stroke, heart attack, and lung cancer) appeared to be lower (51.5%). Non-smokers had a significantly higher likelihood of demonstrating better knowledge on health risks related to AS (OR 1.6) and SHS (OR 1.7) than smokers. Adults with secondary education, college education or above also had significantly higher levels knowledge of AS/SHS health risks than those with primary education (AS: ORs 1.6, 1.7, and 1.9, respectively, and SHS: ORs 2.4, 3.9, and 5.7 respectively). Increasing age was positively associated with knowledge of the health consequences of SHS, and access to information was significantly associated with knowledge of AS/SHS health risks (ORs 2.3 and 1.9 respectively). Otherwise, non-Kinh ethnic groups had significantly less knowledge on health risks of AS/SHS than Kinh ethnic groups. Conclusions: It may be necessary to target tobacco prevention programs to specific subgroups including current smokers, adults with low education, non-Kinh ethnics in order to increase their knowledge on health risks of smoking. Comprehensive messages and/or images about specific diseases related to AS/SHS should be conveyed using of different channels and modes specific to local cultures to increase knowledge on smoking health consequences for general population.

Objective: To examine exposure to second-hand smoke (SHS) at home, in workplace, and in various public places in Bangladesh. Materials and Methods: Data from 2009 Global Adult Tobacco Survey (GATS) conducted in Bangladesh was analyzed. The data consists of 9,629 respondents from a nationally representative multi-stage probability sample of adults aged 15 years and above. Exposure to second-hand smoke was defined as respondents who reported being exposed to tobacco smoke in the following locations: Indoor workplaces, homes, government building or office, health care facilities, public transportation, schools, universities, restaurants, and cafes, coffee shops or tea houses. Exposure to tobacco smoke in these places was examined by gender across various socioeconomic and demographic sub-groups that include age, residence, education and wealth index using SPSS 17.0 for complex samples. Results: The study shows high prevalence of SHS exposure at home and in workplace and in public places. Exposure to SHS among adults was reported high at home (54.9%) (male-58.2% and female-51.7%), in workplace (63%) (male-67.8% and female-30.4%), and in any public place (57.8%) (male-90.4% and female-25.1%) 30 days preceding the survey. Among the public places examined exposure was low in the educational institutions (schools-4.3%) and health care facilities (5.8%); however, exposure was high in public transportation (26.3%), and restaurants (27.6%). SHS exposure levels at home, in workplace and public places were varied widely across various socioeconomic and demographic sub-groups. Conclusions: Exposure was reported high in settings having partial ban as compared to settings having a complete ban. Following the WHO FCTC and MPOWER measures, strengthening smoke-free legislation may further the efforts in Bangladesh towards creating and enforcing 100% smoke-free areas and educating the public about the dangers of SHS. Combining these efforts can have a complementary effect on protecting the people from hazardous effect of SHS as well as reducing the social acceptance of smoking both at home and in public and workplaces. Ongoing surveillance in Bangladesh is necessary to measure progress towards monitoring SHS exposure.

Context: Raising tax on tobacco products is one of the key tobacco control strategies. Globally, it has led to decrease in overall cigarette consumption but on the other hand contributed to increased sale and purchase of loose cigarettes. These loose cigarettes have many important public health implications. Aim: To assess the association between practice of buying loose cigarettes and intensity of smoking. Materials and Methods: A secondary analysis of Global Adult Tobacco Survey, India 2009-2010 data was performed in May 2014, on adult population age 15 years and above. The key outcome variable was "intensity of smoking" defined as average number of cigarettes smoked per day, whereas the key exposure variable was "practice of purchasing loose cigarettes." Descriptive statistical analysis was performed using EpiData software (version 2.2.2.182) and STATA version 12.1. Results: Nearly, 57% of current cigarette smokers (approximately 3.46 million) bought loose cigarettes. The proportion of buying loose cigarettes decreased with increasing level of education and wealth index as well as least among government employees. The intensity of smoking was 70% less among loose cigarette buyers than nonbuyers (odds ratio [OR]: 0.29, 95% confidence interval [CI]: 0.24-0.34). It was found to be significantly lower in rural areas (OR: 0.81, 95% CI: 0.68-0.97) and among homemakers and those who had formal schooling. Conclusion: This study showed that loose cigarette buying is associated with decreased in smoking intensity. This may be due to increased taxes leading to increased buying of single cigarettes. These findings, therefore, highlight a need for a comprehensive policy and further studies on loose cigarette selling. [ABSTRACT FROM AUTHOR]

Introduction: In 2008, Turkey became one of 26 countries with a complete ban on all forms of direct and indirect tobacco marketing. We assessed the level of exposure to anti- and pro-cigarette advertising and to cigarette promotions and sponsorships among various demographic groups in Turkey.Methods: We used the data from the Global Adult Tobacco Survey (GATS), conducted in November 2008 in Turkey. The data consist of answers to GATS questions by 9030 respondents from a nationally representative, multistage probability sample of adults 15 years of age or older. To find differences in exposure to the advertising by sex, age, education level and smoking status, we analyzed responses to GATS questions about cigarette advertisements and anti-cigarette smoking information in various forms and through various advertising channels, during the 30 days before the survey, using bivariate analysis.Results: Overall, 13.3% of respondents aged 15 years or older noticed some type of cigarette marketing during the 30 days before the survey: 7.1% saw advertisements, 5.3% saw promotions and 3.3% saw sports sponsorships. Men were more likely than women to have seen cigarette promotions (7.8% versus 3.0%) and sports sponsorships (5.3% versus 1.4%). Respondents aged 15-24 years were more likely than those aged 25 years or older to have seen cigarette advertisements (10.2% versus 6.2%), promotions (8.7% versus 4.4%) and sponsorships (6.6% versus 2.3%), respectively. Respondents were most likely to have seen cigarette advertisements on television (3.4%) or in shops (2.7%). In addition, 2.8% of respondents reported seeing a clothing item with a brand name or logo, 2.5% reported that they received free samples of cigarettes and 0.3% received gifts along with the purchase of cigarettes. Almost 9 of 10 survey respondents (88.8%) reported having noticed some anti-cigarette information during the 30 days before the survey. Most anti-cigarette information was seen on television (85.5%). The anti-cigarette information was seen by slightly more cigarette smokers (91.6%) than nonsmokers (87.6%). Persons with less than a primary education were less likely to notice anti-cigarette information than those with a higher level of education, in all examined media channels.Conclusions: Our findings showed a low prevalence of noticing cigarette marketing, which indicates high compliance with the Turkish law banning such marketing. GATS data provide an in-depth understanding of the level of exposure to pro- and anti-cigarette information in 2008 and they are of practical assistance to those who implement policies to reduce the demand for tobacco. The challenge now is to maintain rigorous enforcement. To do so requires ongoing surveillance to produce data on the effectiveness of the enforcement efforts. [ABSTRACT FROM AUTHOR]

Introduction: We assessed the differences in exposure to secondhand smoke (SHS) among adults at home, in indoor workplaces, and in various public places in the Philippines across various socio-demographic groups.Methods: Data from the Global Adult Tobacco Survey conducted in 2009 in the Philippines were used. The data consist of survey answers from 9705 respondents from a nationally representative, multistage probability sample of adults aged 15 years or older. We considered that respondents were exposed to SHS if during the previous 30 days they reported that they lived in a home, worked in a building, or visited a public place where people smoked. The public places included in our analysis were indoor workplaces, public transportation vehicles, restaurants, government buildings or offices, and healthcare facilities. The differences in various socioeconomic and demographic groups' exposure to SHS in these places were also examined.Results: Of respondents who reported working indoors, 36.8% were exposed to SHS. Men (43.3% [95% CI 39.7-46.9]) were more likely than women (28.8% [95% CI 25.4-32.4]) to be exposed to SHS (p < 0.001). Of those working in sites where smoking was not allowed, 13.9% were exposed to SHS, whereas 66.5% were exposed where smoking is allowed in some enclosed areas, and 90.7% were exposed where smoking is allowed everywhere. During the 30 days preceding the survey, more than 50% of those who took public transportation were exposed to SHS; exposure for those who visited public buildings was 33.6% in restaurants, 25.5% in government buildings or offices, and 7.6% in healthcare facilities.Conclusion: Despite a national law passed and several local government ordinances that have promulgated smoke-free workplaces, schools, government offices, and healthcare facilities, our findings show that a large proportion of adults were exposed to SHS at work and in public places, which offers opportunities to strengthen and improve enforcement of the smoke-free initiatives and ordinances in the Philippines. [ABSTRACT FROM AUTHOR]

Introduction: We assessed the differences in overall use of tobacco and in the use of various tobacco products, by sex and by frequency of use across various demographic groups.Methods: We used data from the Global Adult Tobacco Survey (GATS), conducted in 2009 in Egypt. The data consist of answers to GATS by 20,924 respondents from a nationally representative, multistage probability sample of adults aged 15 years or older from all regions of Egypt. Current tobacco use was defined as current smoking or use of smokeless tobacco products, either daily or occasionally. We analyzed the differences in current cigarette, shisha, and smokeless tobacco use by sex and frequency of use (daily or occasional); and by demographic characteristics that included age, region, education level and employment status.Results: Overall, 19.7% of the Egyptian population currently use some form of tobacco. Men (38.1% [95% confidence interval (CI) 36.8-39.4]) are much more likely than women (0.6% [95% CI 0.4-0.9]) to use tobacco. Almost 96% of men who use tobacco, do so daily. Men are more likely to use manufactured cigarettes (31.8% [95% CI 30.6-33.1]) than shisha (6.2% [95% CI 5.6-6.9]) or smokeless tobacco (4.1% [95% CI 3.4-4.8]). Few women use tobacco (cigarettes (0.2%), shisha (0.3%) and smokeless tobacco (0.3%)); however, all women who currently smoke shisha, do so daily. Lower educational status, being between ages 25-64 and being employed predicted a higher use of tobacco.Conclusion: Egypt has implemented several initiatives to reduce tobacco use. The World Health Organization (WHO) MPOWER technical package, which aims to reverse the tobacco epidemic, is implemented at various levels throughout the country. Our findings show that there is significant variation in the prevalence of tobacco use and types of tobacco used by adult men and women in Egypt. GATS data can be used to better understand comparative patterns of tobacco use by adults, which in turn can be used to develop interventions. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) MPOWER is a technical package of six tobacco control measures that assist countries in meeting their obligations of the WHO Framework Convention Tobacco Control and are proven to reduce tobacco use. The Global Adult Tobacco Survey (GATS) systematically monitors adult tobacco use and tracks key tobacco control indicators.Methods: GATS is a nationally representative household survey of adults aged 15 and older, using a standard and consistent protocol across countries; it includes information on the six WHO MPOWER measures. GATS Phase I was conducted from 2008-2010 in 14 high-burden low- and middle-income countries. We selected one key indicator from each of the six MPOWER measures and compared results across 14 countries.Results: Current tobacco use prevalence rates ranged from 16.1% in Mexico to 43.3% in Bangladesh. We found that the highest rate of exposure to secondhand smoke in the workplace was in China (63.3%). We found the highest 'smoking quit attempt' rates in the past 12 months among cigarette smokers in Viet Nam (55.3%) and the lowest rate was in the Russian Federation (32.1%). In five of the 14 countries, more than one-half of current smokers in those 5 countries said they thought of quitting because of health warning labels on cigarette packages. The Philippines (74.3%) and the Russian Federation (68.0%) had the highest percentages of respondents noticing any cigarette advertising, promotion and sponsorship. Manufactured cigarette affordability ranged from 0.6% in Russia to 8.0% in India.Conclusions: Monitoring tobacco use and tobacco control policy achievements is crucial to managing and implementing measures to reverse the epidemic. GATS provides internationally-comparable data that systematically monitors and tracks the progress of the other five MPOWER measures. [ABSTRACT FROM AUTHOR]

Background: There is growing concern among policy makers with respect to alarming growth in smoking prevalence among women in the developing countries. Methods: Using disaggregated data from five nationally representative surveys: Global Adult Tobacco Survey 2010, National Family Health Survey-III (NFHS-III) 2004-2005, NFHS-II 1998-1999, National Sample Survey (NSS) 52 nd Round 1995-1996, NSS 50 th Round 1993-1994 we analysed female smoking trend from 1993-2009. Tobacco use among females was monitored for almost two decades focusing on gender, literacy, and state-specific trends among respondents aged >15 years. Results: Smoking use among women has doubled from 1.4% to 2.9% (P < 0.001) during the period 2005-2010. The prevalence of smoking increased with decrease in per capita State Gross Domestic Product and literacy status for both men and women. Conclusion: As the overall smoking prevalence grows, female smoking is growing at a faster rate than smoking among males, which is an emerging concern for tobacco control in India and requires the attention of policymakers.

Background: China has the largest population of smokers in the world, yet the quit rate is low. We used data from the 2010 Global Adult Tobacco Survey China to identify factors influencing quit attempts among male Chinese daily smokers.Methods: The study sample included 3303 male daily smokers. To determine the factors that were significantly associated with making a quit attempt, we conducted logistic regression analyses. In addition, mediation analyses were carried out to investigate how the intermediate association among demographics (age, education, urbanicity) and smoking-related variables affected making a quit attempt.Results: An estimated 11.0% of male daily smokers tried to quit smoking in the 12 months prior to the survey. Logistic regression analysis indicated that younger age (15-24 years), being advised to quit by a health care provider (HCP) in the past 12 months, lower cigarette cost per pack, monthly or less frequent exposure to smoking at home, and awareness of the harms of tobacco use were significantly associated with making a quit attempt. Additional mediation analyses showed that having knowledge of the harm of tobacco, exposure to smoking at home, and having been advised to quit by an HCP were mediators of making a quit attempt for other independent variables.Conclusion: Evidence-based tobacco control measures such as conducting educational campaigns on the harms of tobacco use, establishing smoke-free policies at home, and integrating tobacco cessation advice into primary health care services can increase quit attempts and reduce smoking among male Chinese daily smokers. [ABSTRACT FROM AUTHOR]

The Global Adult Tobacco Survey, or GATS, has proved to be an invaluable tool for policymakers. In India, it highlighted the alarming rates of prevalence of use and risks both nationally and at state level. However, a rapid analysis of GATS-India shows that there are limitations in methods (sampling, questionnaire, measures undertaken to ensure data quality and management), which may impact the estimates of prevalence. This review discusses these potential weaknesses and recommends measures that can be adopted in the next round of surveys to overcome the limitations. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The developing world, including countries like India, has become a major target for the tobacco industry to market its products. This study examines the influence of the marketing (advertising and promotion) of tobacco products on the use of tobacco by adults (ages 15 and over) in India. METHOD: Data from Global Adult Tobacco Survey 2009-2010 was analyzed using methods for complex (clustered) sample designs. Multivariate logistic regression was employed to predict the use of different tobacco products by level of exposure to tobacco marketing using adults who have never used tobacco as the reference category. Odds ratios (ORs) were adjusted for education, gender, age, state of residence, wealth index, and place of residence (urban/rural). RESULTS: Adults in India were almost twice as likely to be current smokers (versus never users) when they were exposed to a moderate level of bidi or cigarette marketing. For bidis, among adults with high exposure, the OR for current use was 4.57 (95% confidence interval [CI]: 1.6, 13.0). Adults were more likely to be current users of smokeless tobacco (SLT) with even a low level of exposure to SLT marketing (OR = 1.24 [95% CI: 1.1, 1.4]). For SLT, the ORs showed an increasing trend (P for trend < 0.001) with greater level of exposure (moderate, OR = 1.55 [95% CI: 1.1, 2.2]; high, OR = 2.05 [95% CI: 0.8, 5.1]). The risk of any current tobacco use rose with increasing level of exposure to any marketing (minimum, OR = 1.25 [1.1-1.4]; moderate, OR = 1.38 [1.1-1.8]; and high, OR = 2.73 [1.8-4.2]), with the trend highly significant (P < 0.001). CONCLUSION: Exposure to the marketing of tobacco products, which may take the form of advertising at the point of sale, sales or a discounted price, free coupons, free samples, surrogate advertisements, or any of several other modalities, increased prevalence of tobacco use among adults. An increasing level of exposure to direct and indirect advertisement and promotion is associated with an increased likelihood of tobacco use. [ABSTRACT FROM AUTHOR]

This study compares current tobacco smokers and smokeless tobacco (SLT) users in terms of their past quitting attempts and intentions to quit in the future, and identifies approaches used in their recent quitting attempts. Data ( n = 14,498) of current tobacco users from two rounds of the Global Adult Tobacco Survey Bangladesh were analysed. Poisson regressions with robust variance were used to examine associations between the study factor and the two outcome variables. About half of smokers and a quarter of SLT users tried to quit during the 12 months before the survey. About two-thirds of smokers and half of SLT users intended to quit in the future. Smokers were more likely (adjusted prevalence ratio (aPR): 1.38, 95%CI: 1.24-1.53) than SLT users to have attempted to quit during the 12 months before the survey and to intend to quit in the future (aPR: 1.09, 95%CI: 1.02-1.16). The corresponding aPRs were even higher for dual users (smoked tobacco and used SLT). Future intention to quit for both smokers (aPR: 1.45, 95%CI: 1.38-1.53) and SLT users (aPR: 1.87, 95%CI: 1.76-1.98) was significantly associated with their past quitting attempts. Most of those who had attempted to quit did not receive any treatment. Proactive and tailored interventions to promote quitting and expansion of tobacco cessation methods are recommended.

Introduction: To examine predictors of current tobacco smoking and smokeless tobacco use among the adult population in Bangladesh.Materials and Methods: We used data from the 2009 Global Adult Tobacco Survey (GATS) in Bangladesh consisting of 9,629 adults aged ≥15 years. Differences in and predictors of prevalence for both smoking and smokeless tobacco use were analyzed using selected socioeconomic and demographic characteristics that included gender, age, place of residence, education, occupation, and an index of wealth.Results: The prevalence of smoking is high among males (44.7%, 95% confidence interval [CI]: 42.5-47.0) as compared to females (1.5%, 95% CI: 1.1-2.1), whereas the prevalence of smokeless tobacco is almost similar among both males (26.4%, 95% CI: 24.2-28.6) and females (27.9%, 95% CI: 25.9-30.0). Correlates of current smoking are male gender (odds ratio [OR] = 41.46, CI = 23.8-73.4), and adults in older age (ORs range from 1.99 in 24-35 years age to 5.49 in 55-64 years age), less education (ORs range from 1.47 in less than secondary to 3.25 in no formal education), and lower socioeconomic status (ORs range from 1.56 in high wealth index to 2.48 in lowest wealth index. Predictors of smokeless tobacco use are older age (ORs range from 2.54in 24-35 years age to 12.31 in 55-64 years age), less education (ORs range from 1.44 in less than secondary to 2.70 in no formal education), and the low (OR = 1.34, CI = 1.0-1.7) or lowest (OR = 1.43, CI = 1.1-1.9) socioeconomic status.Conclusion: Implementation of tobacco control strategies needs to bring special attention on disadvantaged group and cover all types of tobacco product as outlined in the WHO Framework Convention on Tobacco Control (FCTC) and WHO MPOWER to protect people's health and prevent premature death. [ABSTRACT FROM AUTHOR]

Smokefree environment created by smokefree policies is associated with smoking reduction; however, there is paucity of literature on the relationship between smokefree home rules and smoking intensity in low-and-middle income countries (LMICs), and how smokefree policy affects smoking behavior of smokers at different stages of smoking cessation. This study examined the relationship between smokefree home rules and average number of cigarettes smoked per day (CPD) among daily smokers at different stages of the transtheoretical model (TTM) of change. Data from 18,718 current daily cigarette smokers from the Global Adult Tobacco Survey (GATS) conducted from 2011 to 2017 in 20 LMICs were analyzed. Weighted multivariable linear regression analyses were conducted using the log of CPD as the outcome variable with smokefree home rules as the exposure variable, controlling for selected covariates. Approximately 15% of the participants were in precontemplation, 5% were in preparation, 15% lived in partial smokefree homes, and 30% lived in complete smokefree homes. The average number of CPD was 12.3, 12.0, and 10.6 among participants living in homes where smoking was allowed, partial smokefree homes, and complete smokefree homes, respectively. Compared to living in homes where smoking was allowed, living in complete smokefree homes were associated with 22.5% (95%CI = 18.4%-26.5%), 17.9% (95%CI = 8.4%-27.3%), and 29.3% (95% CI = 17.1%-41.5%) fewer CPD among participants in precontemplation, contemplation, and preparation stages, respectively. These findings suggest that complete smokefree home policy will benefit smokers in LMICs irrespective of their intention to quit smoking in addition to protecting non-smokers from secondhand smoke exposure. [ABSTRACT FROM AUTHOR]