title: Prevalence and correlates of smokeless tobacco consumption among married women in rural Bangladesh.
abstract: OBJECTIVE
  To estimate the prevalence and identify correlates of smokeless tobacco consumption among married rural women with a history of at least one pregnancy in Madaripur, Bangladesh.
  
  
  METHODS
  We conducted a cross-sectional survey using an interviewer administered, pre-tested, semi-structured questionnaire. All women living in the study area, aged 18 years and above with at least one pregnancy in their lifetime, who were on the electoral roll and agreed to participate were included in the study. Information on socio-demographic characteristics and smokeless tobacco consumption was collected. Smokeless tobacco consumption was categorized as 'Current', 'Ever but not current' and 'Never'. Associations between smokeless tobacco consumption and the explanatory variables were estimated using simple and multiple binary logistic regression.
  
  
  RESULTS
  8074 women participated (response rate 99.9%). The prevalence of 'Current consumption', 'Ever consumption but not current', and 'Never consumption' was 25%, 44% and 31%, respectively. The mean age at first use was 31.5 years. 87% of current consumers reported using either Shadapata or Hakimpuree Jarda. Current consumption was associated with age, level of education, religion, occupation, being an income earner, marital status, and age at first use of smokeless tobacco. After adjustment for demographic variables, current consumption was associated with being over 25 years of age, a lower level of education, being an income earner, being Muslim, and being divorced, separated or widowed.
  
  
  CONCLUSIONS
  The prevalence of smokeless tobacco consumption is high among rural women in Bangladesh and the age of onset is considerably older than that for smoking. Smokeless tobacco consumption is likely to be producing a considerable burden of non-communicable disease in Bangladesh. Smokeless tobacco control strategies should be implemented.
authors.affiliation: School of Medicine and Public Health, Faculty of Health, The University of Newcastle, New Lambton Heights, New South Wales, Australia.
authors.forename: Mohammad Shakhawat
authors.initials: MS
authors.lastname: Hossain
authors.affiliation: School of Medicine and Public Health, Faculty of Health, The University of Newcastle, New Lambton Heights, New South Wales, Australia.
authors.forename: Kypros
authors.initials: K
authors.lastname: Kypri
authors.affiliation: School of Public Health and Community Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Bayzidur
authors.initials: B
authors.lastname: Rahman
authors.affiliation: Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors.forename: Iqbal
authors.initials: I
authors.lastname: Arslan
authors.affiliation: Directorate General of Health Services, Dhaka, Bangladesh.
authors.forename: Shahnaz
authors.initials: S
authors.lastname: Akter
authors.affiliation: School of Medicine and Public Health, Faculty of Health, The University of Newcastle, New Lambton Heights, New South Wales, Australia.
authors.forename: Abul Hasnat
authors.initials: AH
authors.lastname: Milton
mesh_terms: D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D005260:Female; D006801:Humans; D017533:Marital Status; D008875:Middle Aged; D011247:Pregnancy; D015995:Prevalence; D012424:Rural Population; D064424:Tobacco Use / Q000453:epidemiology*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data*; D055815:Young Adult