Familial and socio-cultural barriers in maintaining tobacco-free homes in Bangladesh: a comparative cross-sectional study

Abstract

ObjectivesChildren, pregnant women and the elderly at a global level are all being dangerously exposed to tobacco use in the household (HH). However, there is no understanding of the familial and socio-cultural factors that provide barriers to ensuring tobacco-free homes in Bangladesh either in urban or rural areas (U&RAs). This study therefore investigates those barriers to help enable a move towards tobacco-free homes in Bangladesh.DesignComparative cross-sectional study.SettingsData were collected from both urban and rural settings in Bangladesh.ParticipantsA probability proportional sampling procedure was used to select 808 participants in U&RAs out of a total of 3715 tobacco users. Semi-structured interviews through the use of a questionnaire were conducted with the participants followed by a multivariate logistic regression analysis of the data in order to explore the familial and socio-cultural factors associated with tobacco use at home.ResultsThe prevalence of tobacco use at home was 25.7% in urban areas and 47.6% in rural areas. In urban areas: marital status (adjusted OR (AOR)=3.23, 95% CI 1.37 to 6.61), education (AOR=2.14, 95% CI 1.15 to 3.99), the smoking habits of elderly family members (AOR=1.81, 95% CI 0.91 to 2.89), offering tobacco as a traditional form of leisure activity at home (AOR=1.85, 95% CI 0.94 to 2.95) and lack of religious practices (AOR=2.39, 95% CI 1.27 to 4.54) were identified as significant socio-cultural predictors associated with tobacco use at home. In rural areas: age (AOR=5.11, 95% CI 2.03 to 12.83), extended family (AOR=3.08, 95% CI 1.28 to 7.38), lack of religious practices (AOR=4.23, 95% CI 2.32 to 7.72), using children to buy or carry tobacco (AOR=3.33, 95% CI 1.11 to 9.99), lack of family guidance (AOR=4.27, 95% CI 2.45 to 7.42) and offering tobacco as a traditional form of leisure activity at home (AOR=3.81, 95% CI 2.23 to 6.47) were identified as significant determinants for tobacco use at home.ConclusionThis study concludes that socio-cultural traditions and familial norms in Bangladesh provide significant barriers for enabling tobacco-free homes. The identification of these barriers can aid policymakers and programme planners in Bangladesh in devising appropriate measures to mitigate the deadly consequences of tobacco use in the home. The consequences also include the dangers involved in family members being exposed to secondhand smoke.

A longitudinal study of transitions between smoking and smokeless tobacco use from the ITC Bangladesh Surveys: implications for tobacco control in the Southeast Asia region

“… 36 For example, unmarried men were more likely to use cigarettes than married men, who have family and dependents. 26 …”

“…Potential covariates (predictors) were selected based on epidemiological knowledge in tobacco control science and previous evidence. 2 , 10 , 24 We considered sex, 25 age group (categorical variable), residential area, 12 socioeconomic status (using the housing index as a proxy), 21 education level, and marital status 26 as covariates to explore the relationship between these sociodemographic factors and product use transitions. The transitions analysis also tested whether there were significant time effects across waves using ITC “wave” (a proxy for time) as a categorical variable (Wave 1–4).…”

Self-medication practice among pregnant and postpartum women attending the regional hospital center of Souss Massa, Morocco: a cross-sectional study

“…The use of medications according to doctor’s prescriptions or instructions has been the subject of several studies. As well, various investigations have pointed to the incidence of self-medication during pregnancy, either in Africa or elsewhere ( Araujo et al, 2013 ; Yimam et al, 2015 ; Cabut et al, 2017 ; Beza, 2018 ; Liao et al, 2018 ; Grover et al, 2019 ; Haque et al, 2020 ; Ake et al, 2021 ; Bobga et al, 2021 ) or worldwide ( Lupattelli et al, 2014 ; Mohseni et al, 2018 ). Health policies, treatment accessibility, and medication distribution regulations are the major factors that make the difference between countries ( Branthwaite and Pechère, 1996 ).…”