title: Investigating socio-economic-demographic determinants of tobacco use in Rawalpindi, Pakistan.
abstract: BACKGROUND
  To investigate the socio-economic and demographic determinants of tobacco use in Rawalpindi, Pakistan.
  
  
  METHODS
  Cross sectional survey of households (population based) with 2018 respondent (1038 Rural; 980 Urban) was carried out in Rawalpindi (Pakistan) and included males and females 18-65 years of age. Main outcome measure was self reported daily tobacco use.
  
  
  RESULTS
  Overall 16.5% of the study population (33% men and 4.7% women) used tobacco on a daily basis. Modes of tobacco use included cigarette smoking (68.5%), oral tobacco (13.5%), hukka (12%) and cigarette smoking plus oral tobacco (6%). Among those not using tobacco products, 56% were exposed to Environmental tobacco smoke. The adjusted odds ratio of tobacco use for rural residence compared to urban residence was 1.49 (95% CI 1.1 2.0, p value 0.01) and being male as compared to female 12.6 (8.8 18.0, p value 0.001). Illiteracy was significantly associated with tobacco use. Population attributable percentage of tobacco use increases steadily as the gap between no formal Education and level of education widens.
  
  
  CONCLUSIONS
  There was a positive association between tobacco use and rural area of residence, male gender and low education levels. Low education could be a proxy for low awareness and consumer information on tobacco products. As Public health practitioners we should inform the general public especially the illiterate about the adverse health consequences of tobacco use. Counter advertisement for tobacco use, through mass media particularly radio and television, emphasizing the harmful effects of tobacco on human health is very much needed.
authors.affiliation: Community Health Sciences, Shifa College of Medicine, Pitrus Bukhari Road, Sector H-8/4, Islamabad, Pakistan. aliyawaralam@gmail.com
authors.forename: Ali Yawar
authors.initials: AY
authors.lastname: Alam
authors.forename: Azhar
authors.initials: A
authors.lastname: Iqbal
authors.forename: Khalif Bile
authors.initials: KB
authors.lastname: Mohamud
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Laporte
authors.forename: Ashfaq
authors.initials: A
authors.lastname: Ahmed
authors.forename: Sania
authors.initials: S
authors.lastname: Nishtar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D012737:Sex Factors; D012907:Smoking / Q000191:economics / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data; D014505:Urban Population / Q000706:statistics & numerical data*
chemical_list: D014028:Tobacco Smoke Pollution