You are here

  • Home
  • Archive
  • Volume 33, Issue 4
  • Trends in smokeless tobacco use and attributable mortality and morbidity in the South-East Asia Region: implications for policy

Article Text

Article menu
Download PDFPDF
Original research
Trends in smokeless tobacco use and attributable mortality and morbidity in the South-East Asia Region: implications for policy
  1. Jagdish Kaur1,
  2. Arvind Vashishta Rinkoo1,
  3. Sol Richardson2
  1. 1 Tobacco Free Initiative, World Health Organization Regional Office for South-East Asia, New Delhi, Delhi, India
  2. 2 Vanke School of Public Health, Tsinghua University, Beijing, China
  1. Correspondence to Dr Sol Richardson, Vanke School of Public Health, Tsinghua University, Haidian District, Beijing 100083, China; srichardson{at}mail.tsinghua.edu.cn

Abstract

Objectives To describe the prevalence of smokeless tobacco (SLT) use and number of users by year, in addition to trends in mortality and attributable disease burden in countries of the WHO South-East Asia Region (SEAR), to inform policies for SLT control in the Region.

Methods For each SEAR country, we obtained data from Global Adult Tobacco Surveys, WHO STEPwise Approach to NCD Risk Factor Surveillance surveys and Demographic and Health Surveys conducted since 2010 to estimate prevalence of SLT use by country, sex and year. Using data from the World Population Prospects database we estimated the number of users by country. Next, using the results of previous meta-analyses and prevalence results, we estimated the population attributable fractions and attributable mortality and morbidity in terms of annual deaths and disability-adjusted life years lost. We then characterised trends in attributable deaths and disease burden for countries with comparable data.

Results There were wide differences in SLT use prevalence by country. We estimated that, during 2015–2019, there were 165 803 900 SLT users across SEAR, with 479 466 attributable deaths annually of which India accounted for 79.9% with 383 248. Attributable annual deaths increased in some countries during 2015–2019.

Conclusions Annual deaths and disease burden attributable to SLT remain high across SEAR and have only declined modestly in recent years. Effective implementation of all WHO Framework Convention on Tobacco Control measures, addressing both supply-side and demand-side issues, in relation to SLT and areca nut products must be prioritised to ensure reductions in mortality and disease burden are sustained and accelerated.

  • non-cigarette tobacco products
  • public policy
  • global health
  • co-substance use

Data availability statement

Data are available upon reasonable request. Data were obtained from the WHO South-East Asia Regional Microdata Repository (available upon reasonable request) and the Demographic and Health Surveys (DHS) programme website (https://dhsprogram.com/data/) for estimates of smokeless tobacco use prevalence. Where data were not available, estimates of prevalence were extracted from relevant reports. Estimates of cause-specific number of annual deaths and disability-adjusted life years (DALYs) lost were obtained from the Global Burden of Disease (GBD) database, available free online at https://vizhub.healthdata.org/gbd-results/.

https://doi.org/10.1136/tc-2022-057669

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    Data are available upon reasonable request. Data were obtained from the WHO South-East Asia Regional Microdata Repository (available upon reasonable request) and the Demographic and Health Surveys (DHS) programme website (https://dhsprogram.com/data/) for estimates of smokeless tobacco use prevalence. Where data were not available, estimates of prevalence were extracted from relevant reports. Estimates of cause-specific number of annual deaths and disability-adjusted life years (DALYs) lost were obtained from the Global Burden of Disease (GBD) database, available free online at https://vizhub.healthdata.org/gbd-results/.

    View Full Text

    Footnotes

    • Contributors JK developed the study concept. SR and AVR conceptualised and conducted the analysis and wrote the first manuscript draft. JK provided critical inputs to subsequent manuscript drafts. All authors read and approved the final manuscript. JK and SR act as co-guarantors for this study.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.