Use of Smoke-less Tobacco Amongst the Staff of Tertiary Care Hospitals in the Largest City of Pakistan

Background: Use of smoke-less tobacco (SLT) is very common in South and South-East Asian countries. It issignificantly associated with various types of cancers. The objectives of this study were to assess the proportionof hospital staff that use SLT, and to identify the factors associated with its use and their practices.
Methods: Ina cross-sectional study, 560 staff of two tertiary care hospitals were interviewed in the year 2009. Nurses, wardboys and technicians were counted as a paramedic staff while drivers, peons, security guards and housekeepingstaff were labeled as non-paramedic staff. SLT use was considered as usage of any of the following: betel quid(paan) with or without tobacco, betel nuts with or without tobacco (gutkha) and snuff (naswar).
Results: Abouthalf (48.6%) of the hospital staff were using at least one type of SLT. Factors found to be statistically significantwith SLT were being a male (OR=2.5; 95% CI=1.8-3.7); having no/fewer years of education (OR=1.7; 95%CI=1.2-2.4) and working as non-paramedic staff (OR=2.6; 95% CI=1.8-3.8). Majority of SLT users were usingit on regular basis, for > 5 years and keeping the tobacco products in the oral cavity for >30 minutes. About halfof the users started due to peer pressure and had tried to quit this habit but failed.
Conclusion: In this study,about half of the study participants were using SLT in different forms. We suggest educational and behavioralinterventions for control of SLT usage.