Smokeless tobacco use more prevalent in pregnant, lactating women in India: Study

Overall, 719 of currently pregnant women and 3,426 of currently married lactating women were using tobacco in some form, the cross-sectional study found after analysing data from the Fifth National Family Health Survey

New Delhi: Smokeless tobacco (SLT) use is more prevalent than smoked tobacco use in pregnant and lactating women in India, even as SLT use is steadily declining over the last few years, new research published in The Lancet Regional Health Southeast Asia journal said.

Overall, 719 (2.5 per cent) of currently pregnant women and 3426 (3.2 per cent) of currently married lactating women were using tobacco in some form, the cross-sectional study from Dr. BR Ambedkar State Institute of Medical Sciences (AIMS), Punjab, and other institutes found after analysing data from the Fifth National Family Health Survey (NFHS-5).

---

Of the 7,24,115 women interviewed in the NFHS-5 survey, 70.7 per cent (5,12,575) were currently married.

Of these, 5.5 per cent (28,408) were pregnant, 616 of whom used smokeless tobacco, 95 used smoked tobacco, and 8 used both smoked and smokeless tobacco, the study found.

Of the currently married population, 20.6 per cent (1,05,482) were lactating at the time of the survey. 2934 (2.8 per cent) of these used smokeless tobacco, 447 (0.4 per cent) used smoked tobacco and 45 (0.04 per cent) used both smoked and smokeless tobacco.

Most (85.6 per cent) of the respondents using tobacco were found to use it in a smokeless form.

The NFHS is a large-scale, multi-round survey conducted in a representative sample of households under the aegis of the Ministry of Health and Family Welfare (MOHFW), Government of India.

The relative popularity of SLT can be attributed to its cheap cost, easy availability and acceptability, the researchers said in the study.

The study revealed a higher SLT use among respondents from the poorest wealth quintile, with tobacco-using pregnant women in central Indian regions more likely to consume ST and combined tobacco and those in the south more likely to consume SLT.

These regional variations may be attributed to cultural influences, a wider acceptance of tobacco use and differences in the implementation of tobacco control policies across the country, the study said.

Traditionally, the use of tobacco during pregnancy has often been reported with seeking a change of taste or to obtain relief from nausea, vomiting, constipation, cold and influenza, the study said.

Comparing rural and urban settings, the study found that the odds of smokeless tobacco use were 19.4 per cent less in rural areas as compared to urban areas among tobacco-using lactating women.

Lactating and pregnant women consuming alcohol showed higher odds of using tobacco than women not drinking alcohol, the study found.

The results indicated inequalities concerning social determinants, thereby reflecting the importance of building evidence on social determinants of tobacco use in Indian women to form policies and tailor interventions to address its root cause, considering their vulnerability to tobacco initiation, the study said.

Thus, there is an urgent need for innovative health promotion and communication strategies using media to raise awareness regarding the harm of all forms of tobacco use among this vulnerable section of the society, the study said.