Is smokeless tobacco use associated with lower health-related quality of life? A cross-sectional survey among women in Bangladesh

Rumana Huque; S M Abdullah; Sayem Ahmed; Nazmul Hossain; Farhin Islam; Mohammad A B Sarker; Md Nurul Amin; Nasiruddin Ahmed

doi:10.18332/tid/185969

Is smokeless tobacco use associated with lower health-related quality of life? A cross-sectional survey among women in Bangladesh

Tob Induc Dis. 2024 Apr 5:22. doi: 10.18332/tid/185969. eCollection 2024.

Authors

Rumana Huque^{1

2}, S M Abdullah^{1

2

3}, Sayem Ahmed⁴, Nazmul Hossain^{1

2}, Farhin Islam², Mohammad A B Sarker⁵, Md Nurul Amin⁵, Nasiruddin Ahmed²

Affiliations

¹ Department of Economics, University of Dhaka, Dhaka, Bangladesh.
² Research and Development, ARK Foundation, Dhaka, Bangladesh.
³ Department of Health Sciences, University of York, York, United Kingdom.
⁴ School of Health & Wellbeing, University of Glasgow, Glasgow, Scotland.
⁵ Health Economics Unit, Health Services Division, Ministry of Health and Family Welfare, Dhaka, Bangladesh.

Abstract

Introduction: Bangladesh has 22 million adult users of smokeless tobacco (ST). The prevalence among women is higher (24.8%). Health-related quality of life outcome (HRQoL) for ST use is little known. We investigated the association between HRQoL and daily ST use among adult women in Bangladesh.

Methods: Using multi-stage design, a cross-sectional survey was conducted. Adult women (randomly selected) were surveyed from 4 purposively selected divisions (Dhaka, Chittagong, Khulna and Rangpur). Female ST users and non-users were compared using HRQoL scores. Self-perceived Visual Analogue Scale (EQ-VAS) values and HRQoL scores were modelled to examine their association with ST use.

Results: A total of 2610 women (1149 users and 1461 non-users) were surveyed. The proportion reported any type of problem in all health dimensions was significantly higher among female ST users than non-users (mobility: 43.3% vs 19.5%, self-care: 29.6% vs 11.9%, usual activities: 48.7% vs 21.8%, pain or discomfort: 69.8% vs 40.6%, and anxiety or depression: 61.3% vs 37.5%). The average HRQoL scores were 0.79 (95% CI: 0.78-0.81) and 0.90 (95% CI: 0.89-0.90) for users and non-users, respectively. Moreover, EQ-VAS average values were significantly higher for non-users [80.7 (95% CI: 79.9-81.6) vs 70.27 (95% CI: 69.2-71.2)]. Controlling the sociodemographics, ST use significantly reduced the HRQoL score by an average of 0.15 points. The EQ-VAS values on average decreased by 0.04 points for ST use.

Conclusions: ST use is significantly associated with the HRQoL of females in Bangladesh. Considering the higher prevalence of ST, especially among women, HRQoL hazards need to be communicated for awareness building.

Keywords: Bangladesh; EQ-5D-5L; Health-Related Quality of Life (HRQoL); smokeless tobacco; women.

Grants and funding

FUNDING This work was supported by the Health Economics Unit (HEU), Health Services Division, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh (grant number: EOI Ref. No. 45.05.0000.007.31.013.20.911) under the Health Nutrition and Population Sector Program (HPNSP). The views expressed in this article are those of the authors and not necessarily of the Health Economics Unit (HEU). R. Huque received the grant to conduct the study.