Smokeless tobacco consumption and its association with risk factors of chronic kidney disease in rural and peri-urban Bangladesh

INTRODUCTION: Compared to smoking, which has major consequences in chronic kidney disease (CKD) initiation and progression, smokeless tobacco (SLT) consumption is considered to have fewer health consequences. We investigated the prevalence of SLT consumption and its association with risk factors of CKD in a rural and peri-urban Bangladeshi population. METHODS: Using random sampling we recruited 872 adults in 2020, from the Mirzapur Demographic Surveillance System of Bangladesh, who had resided in the area for at least five years. Interviews using a semi-structured questionnaire, physical examination and anthropometric measurements were done, followed by blood and urine testing. The blood and urine tests were repeated in selected participants after three months as per the CKD Epidemiology Collaboration equation. RESULTS: The prevalence of SLT consumption was 29%. Being aged ≥46 years (OR=7.10; 95% CI: 4.79-10.94), female (OR=1.64; 95% CI: 1.21–2.22), housewife (OR=1.82; 95% CI: 1.35–2.45), farmer (OR=1.71; 95% CI: 1.06–2.76), widow (OR=3.40; 95% CI: 2.24–5.17), and having no formal schooling (OR=4.91; 95% CI: 3.59–6.72), family income of <$100/month (OR=1.66; 95% CI: 1.13–2.43), sleeping duration <7 hours per day (OR=2.33; 95% CI: 1.70–3.19), were associated with a significantly higher odds of SLT consumption. However, being aged 31–45 years (OR=0.25; 95% CI: 0.16–0.38) had significantly lower odds of being an SLT consumer. Among the diseases investigated, undernutrition (OR=1.63; 95% CI: 1.15–2.33), hypertension (OR=1.52; 95% CI: 1.13–2.05), anemia (OR=1.94; 95% CI: 1.39–2.71) and CKD (OR=1.62; 95% CI: 1.15–2.27) were significantly associated with SLT consumption. In the multivariable analysis, being aged 31–45 years (AOR=3.06; 95% CI: 1.91–4.90), ≥46 years (AOR=15.69; 95% CI: 4.64–53.09) and having no formal schooling (AOR=2.47; 95% CI: 1.72–3.55) were found to have a significant association with being an SLT consumer. CONCLUSIONS: SLT consumption is associated with most of the established risk factors of CKD within the studied population.