Prevailing familial, social and cultural obstacles in keeping tobacco-free homes in urban areas of Bangladesh: A mixed-method study

Abstract

Background Millions of children and others across the world are being dangerously exposed to tobacco smoke and toxins in their own homes. Whilst there is limited interest in laws and interventions controlling tobacco use in public places in Bangladesh, no attention has been given to preventing tobacco-use inside homes. This study explores the familial and socio-cultural factors that provide obstacles for ensuring tobacco-free homes in Bangladesh. Materials and methods A mixed-method design was adopted and from among the 1,436 tobacco users identified in a population of 11,853, 400 (tobacco users) were selected for cross-sectional survey. This survey involved a probability proportional sampling procedure, and 24 In-Depth Interviews. Multivariate logistic regression was performed to explore the association of familial and socio-cultural factors with tobacco-use at home adjusted by other demographic characteristics. Thematic content analysis was done on the qualitative data, and then inferences were drawn out collectively. Results This study revealed that the prevalence of tobacco-use in the home was 25.7% in urban residential areas in Bangladesh. Multivariate logistic regression analysis identified that familial and socio-cultural factors were significantly associated with tobacco-use at home: marital status (OR 3.23, 95% CI: 1.37–6.61), education (OR 2.14, 95% CI: 1.15–3.99), smoking habits of older family members (OR 1.81 95% CI: 0.91–2.89), tobacco being offered as hospitality and for entertainment (OR 1.85, 95% CI: .94–2.95) and lack of religiosity practice (OR 2.39, 95% CI: 1.27–4.54). Qualitative findings indicated that social customs, lack of religious practice, tobacco-use of older family members, and lack of family guidance were key obstacles for enabling tobacco-free homes in urban areas. Conclusion Use of tobacco at home is continuing as part of established familial and socio-cultural traditions. If tobacco-use at home is not addressed seriously by the authorities then the emerging threat of second-hand smoke exposure and harmful consequences of tobacco- use will be exacerbated.

Predictors of parental knowledge of tobacco effects on health and parental perceptions on tobacco control measures at household level in selected urban residential areas of Dhaka city, Bangladesh

“…Both of these two factors were supported by another two studies from USA, and reported that parental self-abstaining from tobacco-use, This study identified that sharing tobacco products at HHs-level should not be considered as the means of hospitality. However, a study conducted in urban areas explored this perception to be significantly associated with promoting the tobacco-use at HH-level (Haque et al 2019). Such offering tobacco to guests and intimate friends who come to visit home is a traditional cultural practice in Bangladesh, and helps to continue the use of tobacco (especially SLT) products in the home environment over generations (Hasib, 2014).…”

“…However, their knowledge and beliefs differ regarding the causation of various health effects. People of urban areas are usually more educated and knowledgeable about the consequences of tobacco use, but that does not mean, they are fully aware of the detrimental impact about tobacco-use atHHs(Haque et al 2019).…”

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

“…Another study conducted in the urban areas of Bangladesh reported that SLT use is perceived as a traditional part of hospitality and is practiced widely at social gatherings such as weddings, baby shower ceremonies, religious events and other occasional festivals. 13 …”

“… 12 The use of tobacco (both smoking and SLT) is common in Bangladesh after having food, tea and snacks both in small and large social gatherings. 13–15 It has been established, however, that such traditions are harmful and detrimental to health and well-being. 13–16 …”

“… 13–15 It has been established, however, that such traditions are harmful and detrimental to health and well-being. 13–16 …”