title: Socio-demographic correlates of betel, areca and smokeless tobacco use as a high risk behavior for head and neck cancers in a squatter settlement of Karachi, Pakistan.
abstract: BACKGROUND
  Head and neck cancers are a major cancer burden in Pakistan. They share a common risk factor profile including regular consumption of products of betel, areca and tobacco. Use of paan, chaalia, gutka, niswar and tumbaku is acceptable in Pakistan and is considered a normal cultural practice. This cross-sectional study was carried out to understand the relation of socio-demographic factors for the consumption of paan, chaalia, gutka, niswar and tumbaku in Pakistani population. Through systematic sampling, 425 subjects from a squatter settlement in Karachi were interviewed using a structured questionnaire. High risk behavior was defined as Daily use of any of the above products.
  
  
  RESULTS
  Daily use of all the substances except chaalia was higher among males compared to females. Chaalia use was higher among adolescents than adults while non-married consumed both chaalia and gutka more than married. Mohajir ethnicity had higher prevalence of paan, gutka and tumbaku use while Pathans had higher prevalence of niswar use.
  
  
  CONCLUSIONS
  Prevalence of use of chewable products is high in Pakistan with particularly high use of certain substances related with socio-demographic profiles. Industrially prepared products, chaalia and gutka, are gaining popularity among youth. Policies and focused interventions can be developed taking into consideration the preferred use of products among different socio-demographic groups.
authors.affiliation: Class of 2006, Aga Khan University - Medical College, Karachi 74800, Pakistan. mrkhawaja@gmail.com.
authors.forename: Samia
authors.initials: S
authors.lastname: Mazahir
authors.forename: Rabia
authors.initials: R
authors.lastname: Malik
authors.forename: Maria
authors.initials: M
authors.lastname: Maqsood
authors.forename: Kanwal Aliraza
authors.initials: KA
authors.lastname: Merchant
authors.forename: Farida
authors.initials: F
authors.lastname: Malik
authors.forename: Atif
authors.initials: A
authors.lastname: Majeed
authors.forename: Zafar
authors.initials: Z
authors.lastname: Fatmi
authors.forename: Muhammad Rizwanulhaq
authors.initials: MR
authors.lastname: Khawaja
authors.forename: Shehzad
authors.initials: S
authors.lastname: Ghaffar