Trends of Smokeless Tobacco use among Adults (Aged 15-49 Years) in Bangladesh, India and Nepal

Background: Smokeless tobacco (SLT) has long been realized as an important component of the fight forglobal tobacco control. It still remains a major problem in countries like India, Bangladesh and Nepal. Theobjective of this study was to estimate the trends of SLT use in three countries of the SEARO WHO office.Materials and
Methods: We used data from national surveys in three countries (Bangladesh, India and Nepal)to estimate trends in prevalence of current SLT use. All available nationally representative data sources wereused. Estimates were weighted, age standardized and given along with 95% confidence intervals. Significance oflinear trend in prevalence over time was tested using the Cochrane-Armitage test for trend. A p value of less than0.05 was considered statistically significant.
Results: We identified three surveys for Bangladesh, three for Indiaand four for Nepal that met the selection criteria (such as Demographic and Health Surveys, WHO-STEPwiseapproach to Surveillance and Global Adult Tobacco Surveys). A significantly increasing trend was noticed in theprevalence of current SLT use among Bangladeshi men (20.2% to 23%, p=0.03). In India, a similar significantlyincreasing trend was seen among men (27.1% to 33.4%, p<0.001) and women (10.1% to 15.7%, p<0.001). InNepal, there was a no significant trend among both men (39.1% to 31.6%, p=0.11) and women (5.6% to 4.7%,p=0.49).
Conclusions: In the study countries SLT use has remained at alarmingly high levels. Usage trends do notshow any signs of decline in spite of control efforts. Tobacco control measures should focus more on controllingSLT use.