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C.T. Sreeramareddy
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OA04 - Epidemiology and Prevention of Lung Cancer (ID 370)
- Event: WCLC 2016
- Type: Oral Session
- Track: Epidemiology/Tobacco Control and Cessation/Prevention
- Presentations: 1
- Moderators:L. Petruželka, S. Shastri
- Coordinates: 12/05/2016, 11:00 - 12:30, Schubert 4
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OA04.01 - Educational and Wealth Inequalities in Tobacco Use among Men and Women in 54 Low-And-Middle-Income Countries (ID 3910)
11:00 - 12:30 | Author(s): C.T. Sreeramareddy
- Abstract
- Presentation
Background:
To support health policies and place monitoring systems to tackle socio-economic inequalities in tobacco use in low-and-middle-income countries (LMIC) are seldom reported. We aimed to describe, sex-wise, educational and wealth-related inequalities in tobacco use in low-and-middle income countries.
Methods:
We analyzed DHS data on tobacco use collected in 54 countries. We calculated weighted prevalence estimates of current tobacco use (any type of tobacco) in each country for five wealth groups and four educational groups. We calculated both absolute and relative measures of inequality, i.e., the Slope Index of Inequality (SII) and Relative Index of Inequality (RII), which take into account the distribution of prevalence across all wealth and education groups and account for population size. We also calculated the aggregate SII and RII for low-income (LIC), lower-middle income (lMIC) and upper-middle-income (uMIC) countries as per World Bank classification.
Results:
Male tobacco use among was highest in Bangladesh (70.3%) lowest in Sao Tome (7.4%); whereas female tobacco use highest in Madagascar (21%) and lowest in Tajikistan (0.22%). Among men educational inequalities varied widely between countries but aggregate RII and SII showed an inverse trend by country wealth groups. RII was 3.61 (95% CI 2.83-4.61) in LICs, 1.99 (95% CI 1.66-2.38) in lMIC, and 1.82 (95% CI 1.24-2.67) in uMIC. Wealth inequalities among men varied less between countries but both RII and SII showed an inverse pattern where RII was 2.43 (95% CI 2.05-2.88) in LICs, 1.84 (95% CI 1.54-2.21) in lMICs, and 1.67 (95% CI 1.15-2.42) in uMIC. For educational inequalities among women, the RII varied much more than SII varied between the countries, and aggregate RII was 14.49 (95% CI 8.87-23.68) in LICs, 3.05 (95% CI 1.44-6.47) in lMIC and 1.58 (95% CI 0.33-7.56) in uMIC. Wealth inequalities among women showed a pattern similar to that of men: the RII was 5.88 (95% CI 3.91- 8.85) in LICs, 1.76 (95% CI 0.80 -3.85) in lMIC, and 0.39 (95% CI 0.09 -1.64) in uMIC. In contrast to men, among women the SII was pro-rich (higher smoking among the more advantaged) in 13 of the 52 countries (7 of 23 lMIC and 5 of 7 uMIC).
Conclusion:
Our results confirm that socio-economic inequalities tobacco use exist in LMIC, varied widely between the countries, and were much wider in the lowest income countries. These findings are important for better understanding and tackling of socio-economic inequalities in health in LMIC.
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P1.01 - Poster Session with Presenters Present (ID 453)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Epidemiology/Tobacco Control and Cessation/Prevention
- Presentations: 1
- Moderators:
- Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)
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P1.01-018 - Tobacco Use and Perceptions about Cessation Training among Health Professions Students: Estimates by Countries and WHO Regions (ID 3911)
14:30 - 15:45 | Author(s): C.T. Sreeramareddy
- Abstract
Background:
Health professionals play an important role in cessation and prevention of tobacco use by providing a brief counseling or even a simple advise to their patients. Smoking habit among health professionals themselves may deter them from providing cessation advice and counseling to their patients. Using GHPSS data, we aim to provide updated global, regional, country-level estimates on prevalence tobacco use among medicine, dentistry, nursing and pharmacy students and describe their attitudes towards tobacco cessation training.
Methods:
The Global Health Professions Student Survey collects data on cigarette smoking and use of other tobacco products, training received to provide patient counselling on cessation techniques etc. We analysed country-wise aggregate data on current cigarette smoking’ (smoking cigarettes ≥1 days during the past 30 days), and ‘current use of tobacco products other than cigarettes’ (chewing tobacco, snuff, bidis, cigars, or pipes ≥1 days during the past 30 days), indicators on ‘health professionals’ role’ and ‘cessation training’. We calculated aggregate rates for each World Health Organization regions using ‘metaprop’ command in Stata-11.
Results:
In 236 surveys from 2005 to 2011 from 70 (medical), 56 (dental), 56 (nursing) and 54 (pharmacy) countries 107,527 students (68,809, girls and 37,886 boys) were surveyed. Overall, in all courses smoking was highest in Europe (20%, medical to 40%, dental students) followed by the Americas (13%, pharmacy to 23%, dental students). Other tobacco use rates were higher in the eastern Mediterranean (10-23%) and Europe (7-13%) countries. Tobaccco use among female students was lowest in Asian and African countries. In countries survyed ≥70% of students agreed that medical professionals are role models and have a role in advicing and information about smoking cessation to their patients and public. In the countries surveyed in all the regions, only about 9.2-36.9% of students (except 80% among dental students in the eastern Mediterranean) reorted that they have received formal training on smoking cessation approaches. and ≥80% of all students agreed they should receive a formal cessation training.
Conclusion:
Health professions students ready to receive cessation training. Tobacco control experts should work with medical educators to discourage tobacco use among health professional students and implement integrated smoking cessation training into their medical curricula. Implications: Our results provide a global snapshot and regional estimates of tobacco use among health professions students and cessation training. Results highlight the need for cessation advice/assistance to health professions students currently using tobacco and the need for introducing cessation training particularly in developing Afro-Asian countries.
