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Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019

Kendrick, Parkes J.; Reitsma, Marissa B.; Abbasi-Kangevari, Mohsen; Abdoli, Amir; Abdollahi, Mohammad; Abedi, Aidin; Abhilash, E. S.; Aboyans, Victor; Adebayo, Oladimeji M.; Advani, Shailesh M.; Ahinkorah, Bright Opoku; Ahmad, Sohail; Ahmadi, Keivan; Ahmed, Haroon; Aji, Budi; Akalu, Yonas; Akunna, Chisom Joyqueenet; Alahdab, Fares; Al-Aly, Ziyad; Alanezi, Fahad Mashhour; Alanzi, Turki M.; Alhabib, Khalid F.; Ali, Tilahun; Alif, Sheikh Mohammad; Alipour, Vahid; Aljunid, Syed Mohamed; Alomari, Mahmoud A.; Amin, Tarek Tawfik; Amini, Saeed; Amu, Hubert; Ancuceanu, Robert; Anderson, Jason A.; Andrei, Catalina Liliana; Andrei, Tudorel; Ansari-Moghaddam, Alireza; Antony, Benny; Anvari, Davood; Arabloo, Jalal; Arian, Nicholas D.; Arora, Monika; Artanti, Kurnia Dwi; Asmare, Wondwossen Niguse; Atnafu, Desta Debalkie; Ausloos, Marcel; Awan, Asma Tahir; Ayano, Getinet; Aynalem, Getie Lake; Azari, Samad; Darshan, B. B.; Badiye, Ashish D.; Baig, Atif Amin; Banach, Maciej; Banerjee, Srikanta K.; Bark...

Authors

Parkes J. Kendrick

Marissa B. Reitsma

Mohsen Abbasi-Kangevari

Amir Abdoli

Mohammad Abdollahi

Aidin Abedi

E. S. Abhilash

Victor Aboyans

Oladimeji M. Adebayo

Shailesh M. Advani

Bright Opoku Ahinkorah

Sohail Ahmad

Keivan Ahmadi

Haroon Ahmed

Budi Aji

Yonas Akalu

Chisom Joyqueenet Akunna

Fares Alahdab

Ziyad Al-Aly

Fahad Mashhour Alanezi

Turki M. Alanzi

Khalid F. Alhabib

Tilahun Ali

Sheikh Mohammad Alif

Vahid Alipour

Syed Mohamed Aljunid

Mahmoud A. Alomari

Tarek Tawfik Amin

Saeed Amini

Hubert Amu

Robert Ancuceanu

Jason A. Anderson

Catalina Liliana Andrei

Tudorel Andrei

Alireza Ansari-Moghaddam

Benny Antony

Davood Anvari

Jalal Arabloo

Nicholas D. Arian

Monika Arora

Kurnia Dwi Artanti

Wondwossen Niguse Asmare

Desta Debalkie Atnafu

Marcel Ausloos

Asma Tahir Awan

Getinet Ayano

Getie Lake Aynalem

Samad Azari

B. B. Darshan

Ashish D. Badiye

Atif Amin Baig

Maciej Banach

Srikanta K. Banerjee

Suzanne Lyn Barker-Collo

Till Winfried Bärnighausen

Hiba Jawdat Barqawi

Sanjay Basu

Mohsen Bayati

Shahrzad Bazargan-Hejazi

Tariku Tesfaye Bekuma

Derrick A. Bennett

Isabela M. Bensenor

Habib Benzian

Catherine P. Benziger

Adam E. Berman

Akshaya Srikanth Bhagavathula

Neeraj Bhala

Nikha Bhardwaj

Pankaj Bhardwaj

Krittika Bhattacharyya

Sadia Bibi

Ali Bijani

Antonio Biondi

Dejana Braithwaite

Hermann Brenner

Andre R. Brunoni

Katrin Burkart

Sharath Burugina Nagaraja

Zahid A. Butt

Florentino Luciano Caetano Dos Santos

Josip Car

Giulia Carreras

Joao Mauricio Castaldelli-Maia

Maria Sofia Sofia Cattaruzza

Jung Chen Chang

Pankaj Chaturvedi

Simiao Chen

Onyema Greg Chido-Amajuoyi

Dinh Toi Chu

Sheng Chia Chung

Liliana G. Ciobanu

Vera Marisa Costa

Rosa A.S. Couto

Baye Dagnew

Xiaochen Dai

Albertino Antonio Moura Damasceno

Giovanni Damiani

Lalit Dandona

Rakhi Dandona

Parnaz Daneshpajouhnejad



Abstract

Background: Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control. Methods: We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period. Findings: In 2019, 273·9 million (95% uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was 4·72% (4·46 to 5·01). 228·2 million (213·6 to 244·7; 83·29% [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15–19 years was over 10% in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: –1·21% [–1·26 to –1·16]), similar progress was not observed for chewing tobacco (0·46% [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 (−0·94% [–1·72 to –0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period. Interpretation: Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.

Citation

Kendrick, P. J., Reitsma, M. B., Abbasi-Kangevari, M., Abdoli, A., Abdollahi, M., Abedi, A., …Soyiri, I. (2021). Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019. The Lancet. Public Health, 6(7), e482-e499. https://doi.org/10.1016/S2468-2667%2821%2900065-7

Journal Article Type Article
Acceptance Date May 27, 2021
Online Publication Date May 28, 2021
Publication Date Jul 1, 2021
Deposit Date Jun 20, 2024
Publicly Available Date Jul 3, 2024
Journal The Lancet Public Health
Electronic ISSN 2468-2667
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 6
Issue 7
Pages e482-e499
DOI https://doi.org/10.1016/S2468-2667%2821%2900065-7
Public URL https://hull-repository.worktribe.com/output/4714058

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