Health knowledge and smokeless tobacco quit attempts and intentions among married women in rural Bangladesh: cross-sectional survey

Introduction and Aims: The aim of this study was to investigate health knowledge, attitudes and smokeless tobacco quit attempts and intentions among married women in rural Bangladesh.

Design and Methods: A cross-sectional survey was conducted using an interviewer administered, pretested, semistructured questionnaire. All 8082 women living in the Jhaudi and Ghotmajhee local government areas, aged ≥18 years with at least one pregnancy in their lifetime, were invited to participate. Questions covered smokeless tobacco consumption (STC), knowledge regarding its health effects, users' quit attempts and intentions and sociodemographic characteristics.

Results: Eight thousand seventy-four women completed the survey (response rate 99.9%). Almost half (45%) of current consumers thought STC was good for their health and many ascribed medicinal values to it, for example 25% thought STC reduced stomach aches. A quarter had previously tried to quit and 10% intended to quit. After adjusting for potential confounders, inaccurate knowledge of STC health consequences was associated with being older [adjusted odds ratio (aOR) = 2.71, 95% confidence interval (CI) 1.99-3.50], less educated (aOR = 2.18, 95% CI 1.66-2.85), Muslim (aOR = 17.0, 95% CI 12.0-23.9) and unemployed (aOR = 29.7, 95% CI: 25.2-35.1). Having less education (aOR = 2.52, 95% CI 0.98-6.45) and being unemployed (aOR = 1.52, 95% CI 1.03-2.23) were associated with the intention to quit.

Discussion and Conclusions: Large gaps exist in rural Bangladeshi women's understanding of the adverse health effects of STC. Health awareness campaigns should highlight the consequences of STC. Routine screening and cessation advice should be provided in primary healthcare and smokeless tobacco control strategies should be implemented.