Was There Any Change in Tobacco Smoking Among Adults in Bangladesh during 2009-2017 Insights from Two Nationally Representative Cross-sectional Surveys

Abstract

Objective: This study assessed the changes in prevalence and associated factors of tobacco smoking among Bangladeshi adults over time. Design: Nationally representative cross-sectional surveys. Setting: Two most recent Global Adults Tobacco Survey (GATS) data from Bangladesh, carried out in 2009 and 2017. Participants: Adult population aged 15 and above (n=9629 in 2009; n=12 783 in 2017). Outcome measures: Current use of tobacco smoke, including cigarettes, bidi, hukkah, cigars or pipes, which was dichotomised ('yes'/'no'). Methods: We analysed data from two recent rounds of GATS (2009 and 2017). Multivariate logistic regression analysis was used. Results: The overall prevalence of tobacco smoking among Bangladeshi adults was noted (23.00%, 95% CI 22.98 to 23.00 in 2009; 16.44%, 95% CI 16.43 to 16.45 in 2017). Being male (adjusted OR (AOR)=59.72, CI 40.56 to 87.93 for 2009; AOR=71.17, CI 41.08 to 123.32 for 2017), age between 25 and 64 years (all AORs >2 and p<0.05), smoking permissible at home (AOR=7.08, CI 5.88 to 8.52 for 2009; AOR=5.90, CI 5.34 to 6.95 for 2017), and watching tobacco smoking product use in movie/drama scenes (AOR=1.26, CI 1.11 to 1.44 for 2009; AOR=1.34, CI 1.17 to 1.54 for 2017) were found to be significantly associated with increased tobacco smoking among adults both in 2009 and in 2017. However, being offered free tobacco sample products (AOR=0.66, CI 0.57 to 0.77 for 2009; AOR=0.87, CI 0.76 to 0.99 for 2017) and having primary, secondary or higher education (all AORs <1 and p<0.05) as well as being a student (AOR=0.16, CI 0.09 to 0.29 for 2009; AOR=0.32, CI 0.19 to 0.53) were associated with lower odds of tobacco smoking in both surveys. Conclusions: Although the prevalence of tobacco smoking has declined over the period, it is still high among those who were relatively older, men, less educated and exposed to a movie/drama where tobacco smoking is promoted. Therefore, appropriate interventions are required to stop tobacco smoking among the Bangladeshi population.