Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys
Objective Tobacco use begins at an early age and typically leads to a long-term addiction. The age of initiation for tobacco use is not well studied in South Asia, where 22% of tobacco smokers and 81% of smokeless tobacco (SLT) users reside.Methods Data from the nationally representative Global Adul...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-12-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/12/e067875.full |
| _version_ | 1797369698198749184 |
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| author | Lucky Singh Prashant Kumar Singh Ankur Singh Shalini Singh Amit Yadav Pranay Lal Chandan Kumar Pankhuri Jain |
| author_facet | Lucky Singh Prashant Kumar Singh Ankur Singh Shalini Singh Amit Yadav Pranay Lal Chandan Kumar Pankhuri Jain |
| author_sort | Lucky Singh |
| collection | DOAJ |
| description | Objective Tobacco use begins at an early age and typically leads to a long-term addiction. The age of initiation for tobacco use is not well studied in South Asia, where 22% of tobacco smokers and 81% of smokeless tobacco (SLT) users reside.Methods Data from the nationally representative Global Adult Tobacco Surveys in India, Bangladesh and Pakistan were analysed to examine patterns of initiation among smokers and smokeless tobacco users.Results Data on 94 651 individuals were analysed, of which 13 396 reported were ever daily smokers and 17 684 were ever SLT users. The proportion of individuals initiating tobacco use before the age of 15 years has increased over time. The rates of SLT initiation among those aged 15–24 years increased markedly in Bangladesh (by 7.8%) and Pakistan (by 37.7%) between 1983 and 1999–2000. Among males, the increase in SLT initiation was higher in individuals aged below 15 years compared with other age groups in India and Bangladesh. Smoking initiation among females aged below 15 years has also significantly increased in India over time. Compared with the initiation of tobacco smoking before the age of 15 years, a greater increase in the proportion of SLT users was observed in urban areas.Conclusion Our findings indicate that the proportion of youth initiating tobacco (both smoking and smokeless) before the age of 15 years has increased over time in all three countries. Moreover, variations in age at initiation for different types of tobacco products across countries, and by rurality, were noticeable. Younger youths (aged up to 15 years) should therefore be a priority population for tobacco control interventions. Strategies such as raising the legal age of tobacco sale and use to 21 years, and, other measures under WHO Framework Convention on Tobacco Control (FCTC), may prevent underage use and avert lifelong addiction to tobacco products. |
| first_indexed | 2024-03-08T17:51:36Z |
| format | Article |
| id | doaj.art-ebc520771cf040b1986c9ba195252df5 |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-08T17:51:36Z |
| publishDate | 2023-12-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-ebc520771cf040b1986c9ba195252df52024-01-02T08:15:07ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2022-067875Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveysLucky Singh0Prashant Kumar Singh1Ankur Singh2Shalini Singh3Amit Yadav4Pranay Lal5Chandan Kumar6Pankhuri Jain7ICMR-National Institute of Medical Statistics, New Delhi, IndiaDivision of Preventive Oncology & Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, IndiaCentre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, AustraliaDivision of Preventive Oncology & Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, IndiaInternational Union Against Tuberculosis and Lung Disease (The Union), South East Asia Office, New Delhi, IndiaIndependent Public Health Researcher, New Delhi, IndiaDepartment of Policy & Management Studies, TERI School of Advanced Studies, New Delhi, IndiaDivision of Preventive Oncology & Population Health, ICMR-National Institute of Cancer Prevention and Research, Noida, Uttar Pradesh, IndiaObjective Tobacco use begins at an early age and typically leads to a long-term addiction. The age of initiation for tobacco use is not well studied in South Asia, where 22% of tobacco smokers and 81% of smokeless tobacco (SLT) users reside.Methods Data from the nationally representative Global Adult Tobacco Surveys in India, Bangladesh and Pakistan were analysed to examine patterns of initiation among smokers and smokeless tobacco users.Results Data on 94 651 individuals were analysed, of which 13 396 reported were ever daily smokers and 17 684 were ever SLT users. The proportion of individuals initiating tobacco use before the age of 15 years has increased over time. The rates of SLT initiation among those aged 15–24 years increased markedly in Bangladesh (by 7.8%) and Pakistan (by 37.7%) between 1983 and 1999–2000. Among males, the increase in SLT initiation was higher in individuals aged below 15 years compared with other age groups in India and Bangladesh. Smoking initiation among females aged below 15 years has also significantly increased in India over time. Compared with the initiation of tobacco smoking before the age of 15 years, a greater increase in the proportion of SLT users was observed in urban areas.Conclusion Our findings indicate that the proportion of youth initiating tobacco (both smoking and smokeless) before the age of 15 years has increased over time in all three countries. Moreover, variations in age at initiation for different types of tobacco products across countries, and by rurality, were noticeable. Younger youths (aged up to 15 years) should therefore be a priority population for tobacco control interventions. Strategies such as raising the legal age of tobacco sale and use to 21 years, and, other measures under WHO Framework Convention on Tobacco Control (FCTC), may prevent underage use and avert lifelong addiction to tobacco products.https://bmjopen.bmj.com/content/13/12/e067875.full |
| spellingShingle | Lucky Singh Prashant Kumar Singh Ankur Singh Shalini Singh Amit Yadav Pranay Lal Chandan Kumar Pankhuri Jain Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys BMJ Open |
| title | Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys |
| title_full | Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys |
| title_fullStr | Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys |
| title_full_unstemmed | Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys |
| title_short | Trends in age of tobacco use initiation over time in Bangladesh, India and Pakistan: analysis of cross-sectional nationally representative surveys |
| title_sort | trends in age of tobacco use initiation over time in bangladesh india and pakistan analysis of cross sectional nationally representative surveys |
| url | https://bmjopen.bmj.com/content/13/12/e067875.full |
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