title: Dual use of tobacco among Bangladeshi men.
abstract: BACKGROUND
  Dual use of tobacco (using smoking and smokeless forms) in Bangladesh is uncommon in women but common in men. Dual users are at additional risk of cancers and heart diseases compared with a single form of tobacco use. Knowledge about their socioeconomic background is necessary for planning appropriate interventions. We report here socioeconomic background of the dual users of tobacco from a nationally representative survey.
  
  
  METHODS
  The study adopted a probability proportionate to size sampling technic of divisional population stratified into urban and rural areas to recruit men aged 25 years or older from their households. A total of 4312 men were recruited. Variables included questions on 20 household assets, tobacco use and other behavioral risk factors, and measurement of body weight and height.
  
  
  RESULTS
  The average age of dual users was 46.7 years old compared to 43.4 and 52.3 years for smokers and smokeless tobacco users. Prevalence of "smoking only," "smokeless only" and "dual use" of tobacco was 40.6%, 15.2%, and 14.2%, respectively. Among all tobacco users, dual users constituted 20%. These dual users had lower educational achievement, rural residence, lower intake of fruit, and higher intake of alcohol. They were more undernourished as indicated by a thin body mass index compared to nonusers and smokers. Dual users were of socioeconomically deprived as measured by wealth quartiles constructed out of household assets.
  
  
  CONCLUSIONS
  Dual use of tobacco is common in Bangladesh, and it is intimately linked with socioeconomic deprivation. Poverty reduction strategy and campaigns should address tobacco control not only tobacco in general, but its dual use in particular.
authors.affiliation: World Health Organization, Dhaka, Bangladesh.
authors.forename: M M
authors.initials: MM
authors.lastname: Zaman
authors.forename: M R
authors.initials: MR
authors.lastname: Bhuiyan
authors.forename: S M
authors.initials: SM
authors.lastname: Huq
authors.forename: M M
authors.initials: MM
authors.lastname: Rahman
authors.forename: D N
authors.initials: DN
authors.lastname: Sinha
authors.forename: T
authors.initials: T
authors.lastname: Fernando
mesh_terms: D000328:Adult; D000368:Aged; D001459:Bangladesh; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014030:Tobacco, Smokeless / Q000009:adverse effects*; D014944:World Health Organization; D055815:Young Adult