- Title
- Smokeless tobacco consumption in Bangladesh: trends, knowledge of health effects and current policy
- Creator
- Naznin, Eva
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2021
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: Smokeless tobacco consumption is prevalent in Bangladesh and associated with several diseases, including a variety of cancers, and poor maternal and infant outcome. Objectives: The intention of the thesis research was to examine the extent of the smokeless tobacco problem in Bangladesh, and opportunities for strengthening Bangladesh’s response to smokeless tobacco use. There were three specific objectives of the thesis: Firstly, estimating the pooled prevalence of smokeless tobacco consumption by gender and location in Bangladesh, India and Myanmar and identifying periodic changes in smokeless tobacco prevalence using data extracted from published studies. The second objective was to explore perceptions of key stakeholders with respect to Smokeless tobacco control policy in Bangladesh and its alignment with the World Health Organization’s Framework Convention on Tobacco Control (FCTC). Thirdly, examining public knowledge of the health effects of smoking and smokeless tobacco consumption in Bangladesh over time (2009-2015). Methods: To address the first objective, a meta-analysis was carried out to estimate pooled prevalence of smokeless tobacco consumption and confidence intervals in Bangladesh, India, and Myanmar. To address objective two, semi-structured key informant interviews were conducted in Bangladesh with 20 stakeholders from government and non-government offices and international funding agencies. Finally, International Tobacco Control Bangladesh survey data was used to examine trends in public knowledge of the health effects of smoking and smokeless tobacco consumption in Bangladesh. Findings: We found significant decreases in smokeless tobacco consumption in Bangladesh (chi square = 1241; p<0.05) and India (chi square = 445.56; p<0.05) between 2010 and 2014, and 2015 and 2019, respectively. Prevalence increased significantly in Myanmar (chi square = 1402.93; p<0.05) between 2010 and 2014. Bangladesh has adopted some important FCTC measures, though implementation of legislation remains ineffective regarding graphic health warnings and tax measures. From 2010 to 2015, knowledge of the health effects of cigarette smoking and smokeless tobacco use has increased in Bangladesh. Regarding knowledge of the health effects from cigarette smoking, an estimated increase in mean knowledge score was observed of 0.640 (95% CI 0.537, 0.742) from 2010 to 2012 and 0.555 (95% CI 0.465, 0.645) from 2012 to 2015, respectively. Likewise, increased odds of knowledge were also evident for smokeless tobacco health effects between 2012 and 2015 for mouth cancer 4.397 (95% CI 3.393, 5.699) and difficulty in opening mouth 1.464 (95% CI 1.243, 1.725). Discussion and conclusion: The findings will increase the knowledge base regarding smokeless tobacco consumption in Bangladesh and proper policy implementation for smokeless tobacco control in Bangladesh specifically for graphic health warning, control of illicit trade, formulating country specific policy and offer help to quit by confirming proper use of tobacco control resources. This new knowledge will inform future tobacco control policy development in Bangladesh, particularly about the inclusion of smokeless tobacco into that policy.
- Subject
- smokeless tobacco; Bangladesh; framework convention on tobacco control; policy implementation; health knowledge; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1510707
- Identifier
- uon:56443
- Rights
- Copyright 2021 Eva Naznin
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
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| View Details Download | ATTACHMENT01 | Thesis | 4 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 1 MB | Adobe Acrobat PDF | View Details Download |