Smokeless tobacco use among women in northeastern states, India: A study of spatial clustering and its determinants using National Family Health Survey-4 data
Kh. Jitenkumar Singh, Nirendra Haobijam, Saritha Nair, Aheibam Sharmila Devi, Sagolsem Roshan Singh, Meena Hijam, Nongzaimayum Tawfeeq Alee, Saurabh Sharma, Vijit Deepani, Lucky Singh, M. Vishnu Vardhana Rao
Abstract
Background: Use of tobacco, especially smokeless tobacco have characterised as highly prevalent among women, and also the mode of using smokeless tobacco varies based on geographic location, ingredient availability, cultural/societal norms, and personal preferences. Therefore, this study examines the prevalence and social determinants of use of smokeless tobacco among women in NE India. Further, it also identifies the cluster and district hotspots of smokeless tobacco prevalence. Methods: We analysed a nationally representative data of NFHS-4, covering 93,409 eligible women aged 15-49 years from a survey of representative households from NE states, India. Descriptive statistics, chi-square, binary logistic and log-binomial regression were employed to analyse the data by using STATA software 13.1. Spatial clustering analysis and hotspot analysis were carried out using R-library. Findings: The prevalence of SLT use among women in NE states, India is 23%. Mizoram (47.8 1.2) shows the highest prevalence of SLT use, followed by Manipur (46.1 0.7). It increases concomitantly with age among women. Social determinants like marital status (divorced/widowed), low educational level and residence (urban) were observed to be associated with smokeless tobacco use. Out of the 4032 clusters used in the analysis, 949 clusters were showed as hotspots.