Gender and locality differences in tobacco prevalence among adult Bangladeshis

OBJECTIVES: To determine the extent of all forms of tobacco usage in adult Bangladeshis in relation to gender and locality. METHODS: Three annual urban and rural cross-sectional surveys were carried out between 2001 and 2003 involving a total of 35 446 adults, of whom 54.3% were female and 51.0% were rural dwellers. Data were collected through interview using a structured questionnaire. RESULTS: The overall prevalences of smoking, chewing tobacco and gul usage were 20.5%, 20.6% and 1.8%, respectively. Current smoking and gul usage were significantly higher in males (42.2% and 2.2%, respectively) than females (2.3% and 1.5%, respectively) while chewing tobacco was more common in females (21.6%) than males (19.4%). No significant urban-rural difference was observed in smoking rate after adjusting for sociodemographic variables, while chewing tobacco was 1.5 times more likely to occur in rural residents and gul usage was 3.6 times more likely to occur in urban residents. On average a smoker consumed 9.3 sticks a day with males and rural residents smoking more. CONCLUSIONS: Nearly a third of the population in Bangladesh use some form of tobacco. There are marked urban-rural and male-female differences. This difference is mainly accounted for by the higher prevalence of chewing tobacco in rural areas, rural female tobacco usage is close to double than the urban rate. Smoking rates were low in Bangladeshi females, more so in urban than rural areas. The tobacco awareness programme in Bangladesh might require putting emphasis on smokeless tobacco as well as smoking.