title: Predictors of oral tobacco use among young adult patients visiting family medicine clinics in Karachi, Pakistan.
abstract: Prevalence of cancers associated with the use of oral tobacco (OT) is rising very rapidly and prevention of use is the best option to tackle this scenario. This cross-sectional study estimated the proportion of OT use and predictors associated with its initiation and determined the knowledge, attitude and practices of OT users. A total of 231 young adult patients (15-30 years age) were interviewed by medical students in family practice clinics in Karachi, Pakistan. OT use was considered as usage of any of the following: betel quid (paan) with tobacco, betel nuts with tobacco (gutkha), and snuff (naswar). Overall, 49.8% (95% CI=43.3-56.2) subjects had used OT at least in one form. Multivariable analysis demonstrated independent association of OT users with secondary education level (adjusted OR=3.6; 95% CI=1.6-8.1) and use of OT by a family member (OR=2.3; 95% CI=1.3-4.0). Among OT users, 37.4% started after being inspired by friends/peer pressure, 60% using for more than 5 years, 53.2 % users reported getting physical/mental comfort from the use of OT while 31.6% tried to quit this habit but failed. We suggest socially and culturally acceptable educational and behavioral interventions for control of OT usage and hence to prevent its associated cancers.
authors.affiliation: Department of Family Medicine, Aga Khan University, East Africa.
authors.forename: Raheem
authors.initials: R
authors.lastname: Dhanani
authors.forename: Asif
authors.initials: A
authors.lastname: Jafferani
authors.forename: Nizar
authors.initials: N
authors.lastname: Bhulani
authors.forename: Syed Iqbal
authors.initials: SI
authors.lastname: Azam
authors.forename: Ali Khan
authors.initials: AK
authors.lastname: Khuwaja
mesh_terms: D000328:Adult; D001114:Areca; D003430:Cross-Sectional Studies / Q000379:methods; D005194:Family Practice; D005260:Female; D005544:Forecasting; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009369:Neoplasms / Q000517:prevention & control; D010154:Pakistan / Q000453:epidemiology; D010353:Patient Education as Topic; D015995:Prevalence; D012307:Risk Factors; D013337:Students, Medical; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014030:Tobacco, Smokeless; D055815:Young Adult