Predictors of Oral Tobacco Use Among Young Adult Patients Visiting Family Medicine Clinics in Karachi, Pakistan

Prevalence of cancers associated with the use of oral tobacco (OT) is rising very rapidly and prevention ofuse is the best option to tackle this scenario. This cross-sectional study estimated the proportion of OT use andpredictors associated with its initiation and determined the knowledge, attitude and practices of OT users. Atotal of 231 young adult patients (15-30 years age) were interviewed by medical students in family practice clinicsin Karachi, Pakistan. OT use was considered as usage of any of the following: betel quid (paan) with tobacco,betel nuts with tobacco (gutkha), and snuff (naswar). Overall, 49.8% (95% CI=43.3-56.2) subjects had used OTat least in one form. Multivariable analysis demonstrated independent association of OT users with secondaryeducation level (adjusted OR=3.6; 95% CI=1.6-8.1) and use of OT by a family member (OR=2.3; 95% CI=1.3-4.0). Among OT users, 37.4% started after being inspired by friends/peer pressure, 60% using for more than5 years, 53.2 % users reported getting physical/mental comfort from the use of OT while 31.6% tried to quitthis habit but failed. We suggest socially and culturally acceptable educational and behavioral interventions forcontrol of OT usage and hence to prevent its associated cancers.