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Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 19902019: a systematic analysis from the global burden of disease study 2019

Citation

Kendrick, PJ and Reitsma, MB and Antony, B and Singh, Ambrish and Gakidou, E, GBD 2019 Chewing Tobacco Collaborators, Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: a systematic analysis from the global burden of disease study 2019, The Lancet Public Health, 6, (7) pp. E482-E499. ISSN 2468-2667 (2021) [Refereed Article]

DOI: doi:10.1016/S2468-2667(21)00065-7

Abstract

Background

Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control.

Methods

We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period.

Findings

In 2019, 2739 million (95% uncertainty interval 2585 to 2909) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 472% (446 to 501). 2282 million (2136 to 2447; 8329% [8215 to 8442]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 1519 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: 121% [126 to 116]), similar progress was not observed for chewing tobacco (046% [013 to 079]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (−094% [172 to 014]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period.

Interpretation

Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence.

Item Details

Item Type:Refereed Article
Keywords:Disease burden
Research Division:Health Sciences
Research Group:Epidemiology
Research Field:Disease surveillance
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Determinants of health
UTAS Author:Antony, B (Dr Benny Eathakkattu Antony)
UTAS Author:Singh, Ambrish (Mr Ambrish Singh)
ID Code:144927
Year Published:2021
Web of Science® Times Cited:3
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-06-21
Last Modified:2022-04-08
Downloads:0

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