Smokeless tobacco consumption in the South Asian population of Sydney, Australia: prevalence, correlates and availability

Aim. The aim of this study was to estimate the prevalence and identify correlates of smokeless tobacco consumption among the South Asian residents of Sydney, Australia. Methods. A cross-sectional survey was conducted using a pretested, self-administered mailed questionnaire among members of Indian, Pakistani and Bangladeshi community associations in Sydney. Results. Of 1600 individuals invited to participate, 419 responded (26%). Prevalence rates of ever consumption, more than 100 times consumption and current consumption were 72.1%, 65.9% and 17.1%, respectively. Men (74.3%) were more likely to ever consume than women (67.6%). Over 96% of consumers reported buying smokeless tobacco products from ethnic shops in Sydney. Current consumption of smokeless tobacco products was associated with country of birth: Indians (odds ratio 5.7, 95% confidence interval 2.3-14.5) and Pakistanis (odds ratio 3.1, 95% confidence interval 1.5-6.5) were more likely to be current consumers than Bangladeshis after adjusting for sociodemographic variables. For ever consumption, there was a positive association with age (P for trend=0.013) and male gender (odds ratio 2.1, 95% confidence interval 1.5-3.1). Conclusions. Given the availability of smokeless tobacco and the high prevalence and potential adverse health consequences of consumption, smokeless tobacco consumption may produce a considerable burden of non-communicable disease in Australia. Effective control measures are needed, in particular enforcement of existing laws prohibiting the sale of these products.