Prevalence of tobacco use in urban and rural areas of Pakistan; a sub-study from second National Diabetes Survey of Pakistan (NDSP) 2016 - 2017: Prevalence of tobacco use in Pakistan

Objective: To assess age standardized prevalence of tobacco use in urban and rural areas of Pakistan.

Methods: This is a sub-study of second National Diabetes Survey of Pakistan (NDSP) 2016-2017. Prevalence of tobacco, ex-tobacco and non-tobacco users was determined in urban/rural areas of four provinces (Punjab, Sindh, Khyber Pakhtunkhwa, and Baluchistan) of Pakistan amongst people aged greater than or equal to 20 years. Information regarding tobacco and non-tobacco users were obtained from second NDSP (2016-2017) predesigned questionnaire. Detailed methodology for demographic, anthropometric and biochemical parameters remained same as reported in second NDSP (2016-2017).

Results: The age-standardized prevalence of tobacco use in Pakistan was found to be 13.4%. Tobacco use in urban areas was 16.3% and rural areas was 11.7%. Tobacco use in urban and rural males was 26.1% and 24.1%, while in females was 7.7% and 3.1%, respectively. The age-standardized prevalence of ex-tobacco use in Pakistan was found to be 2.3%. Ex-tobacco use in urban areas was 2.6% and rural areas was 2.3%. Similarly, ex-tobacco use in urban and rural males was 4.6% and 4.6%, while in females was 0.7% and 0.5%, respectively. Multinomial logistic regression analysis shows that increasing age does not relate towards addiction of tobacco. Males were found to be 7 times (OR 6.94, 95% CI 5.68-8.49) and urban residents twice (OR 2.09, 95% CI 1.73-2.52) more tobacco users than females and those living in rural areas, respectively. From the likelihood ratio test, all variables were found to be statistically significant except for dysglycemia, dyslipidemia and hypertension.

Conclusion: The prevalence of tobacco use is high. As a sub paper of a large national survey, this evidence is expected to serve as an important tool to plan larger studies leading in turn to develop strategies for a successful tobacco control program in the country.