KARACHI: An alarmingly large number of women in Orangi Town are hooked to tobacco, says a recent study that calls for immediate preventive measures to control the use of the hazardous substance that not only puts women at a great risk of developing multiple illnesses but can also endanger and complicate pregnancy.

The overall prevalence rate of tobacco use among women was found to be at 65 per cent.

Titled ‘Prevalence of tobacco use among women: a cross sectional survey from a squatter settlement’, the yet-to-be published study was conducted by the Aga Khan University in collaboration with the All Pakistan Women’s Association and the National Alliance of Tobacco Control.

Over 16,000 women aged between 15 and 80 years were interviewed in Orangi Town in 2012 during the study. Of them, 90pc were married.

According to the findings, 54pc women admitted that at least one person in their family consumed tobacco in some form. The prevalence of smokeless (oral consumption) and smoke tobacco use among women was 42.25pc and 18pc, respectively.

Among smokers, 85pc admitted that they had tried to quit smoking over the last 12 months but failed while 79pc said that they had received medical advice to quit smoking.

“The most common form of tobacco use found among women was smokeless. About 42pc of women used such tobacco on a daily basis compared to 18pc of women who smoked.

“Around five per cent of women had tobacco in a mixed form. Out of women who smoked tobacco, 68pc smoked cigarettes and 26pc smoked sheesha and 6pc smoked hookah,” says the survey.

It was seen that since majority of women were illiterate and poor, they had not read any information regarding harmful effects of smoking. However, women smokers agreed that the picture on cigarette packs showing hazards of tobacco use does create a frightening feeling against smoking.

The study indicates that the prevalence of smokeless tobacco use has increased to 42pc while that of smoke tobacco use to 18pc. That puts the overall prevalence rate of tobacco use among women at 65pc.

The National Household Survey done in 2012, however, had shown negligible use of tobacco among women in Pakistan. The prevalence of passive smoking incidence (12pc) is also found to be high as compared to the last survey.

Also, it points out, the World Health Survey (2002-2003) carried out in Pakistan showed that the prevalence of any form of smoking tobacco among adults was 20pc (33.5pc for males and 6.2pc for females).

Referring to the WHO statistics, the study says that whereas the prevalence of tobacco use is slowly declining in the developed world, it has been steadily rising in the developing countries where women and youth have been the target of tobacco advertising strategies and there is an increase in smoking prevalence among women in these countries.

Tobacco use, it says, accounts for six million deaths each year and there has been a dramatic rise in tobacco-related lung diseases among women in the developing countries.

“The Asia Pacific region is the fastest growing tobacco market in the world, with four out of the 10 rapidly growing countries being Malaysia, Indonesia, Pakistan and Vietnam,” the study says, citing the Asian agricultural report 2014.

On the prevalence of smoking among adolescent female population in Pakistan, it says it has also increased to 16.3pc. The mean age for trying to smoke cigarettes is 15 years for girls and there is also a rapid increase in both the use of smokeless tobacco as well as its inhaled forms.

“Tobacco in Pakistan is used in much more culturally acceptable forms like hookah, naswar, betel quid and gutka. Oral tobacco leads to cancer of head and neck. It is reported that about 58pc of head and neck cancers worldwide occur in South and South East Asia alone and they constitute a major burden in Pakistan.

“This necessitates that tobacco control strategies in Pakistan should focus not only on cigarette smoking, but also on oral tobacco consumption. Low level of education and poverty remain a big obstacle to the fight against tobacco,” it says.

Citing a study involving pregnant women at Liaquat University of Medical and Health Sciences, Hyderabad, it says that it showed peer pressure and depression were two major factors for women to get hooked to tobacco, especially smoking.

Nearly 55pc of deaths in the country, the study says, are caused by non-communicable diseases and tobacco use is one of the biggest preventable risk factor.

“Pakistan scored very poorly in terms of compliance with smoke-free legislation for public places. Considering the prevalence of culturally acceptable forms of tobacco among females, it’s a cause for concern that there is no regular monitoring of smokeless tobacco in the country, nor are there any health warnings on smokeless tobacco products,” the study says, citing the 2011 WHO report titled ‘Global tobacco epidemics’.

The study recommends strengthening of public health efforts, curtailment of all forms of tobacco advertisement, sponsorship and marketing strategies as well as enforcing strict laws to ban the use of not only cigarette but also smokeless tobacco.

It calls for creating public awareness so as to discourage tobacco use while underlining the need for having pictorial health warnings on smokeless tobacco products, the prevalence of which, it says, is higher among women with lower literacy rate.

Published in Dawn, June 22nd, 2015

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