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Pattern of Tobacco Use Among the Iranian Adult

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Pattern of Tobacco Use Among the Iranian Adult Research paper Tob Control: first published as 10.1136/tc.2009.030759 on 11 December 2009. Downloaded from Pattern of tobacco use among the Iranian adult population: results of the national Survey of Risk Factors of Non-Communicable Diseases (SuRFNCD-2007) Alipasha Meysamie,1 Reza Ghaletaki,1 Mehrdad Haghazali,2 Fereshteh Asgari,2 Armin Rashidi,3 Omid Khalilzadeh,3 Alireza Esteghamati,3 Mehrshad Abbasi3,4 1Department of Community and ABSTRACT uals.1 Recent prevalence estimates for low and Preventive Medicine, Faculty of Background Previous studies report on smoking in Iran middle-income countries are 49% for men and 8% Medicine, Tehran University but recent national data on tobacco use (including for women.5 In addition, the harmful effects of of Medical Sciences/university of Tehran, Tehran, Iran cigarette, water-pipe and pipe) have not been reported. passive smoking affect those people around 2Centre for Disease Control and Methods In 2007, 5287 Iranians aged 15e64 years smokers.67 Management, Tehran, Iran were sampled from all provinces as part of a national To decrease the prevalence of tobacco use and to 3 Endocrinology and Metabolism cross-sectional survey of non-communicable disease eliminate its related dangers, it is necessary to have Research Centre, Department of Endocrinology, Vali-asr Hospital, (NCD) risk factors. Data were collected using the a general view of the current condition. The Tehran University of Medical standardised stepwise protocol for NCD risk factor purpose of this article is to demonstrate the extent Sciences/University of Tehran surveillance of the World Health Organization. Use of of tobacco smoking in Iran in different strata of age, Tehran, Iran 4 tobacco products was calculated as the sum of smoking sex and residential area based on information from Nuclear Medicine Research cigarettes/cigars (smoking currently or daily any amount the third national Surveillance of Risk Factors of Center, Shariati Hospital, Tehran University of Medical of factory/hand-made cigarettes or cigars), pipes (daily) Non-Communicable Diseases (SuRFNCD, 2007). Sciences/University of Tehran, and water pipes (daily). Tehran, Iran Results Total current and daily tobacco use was 14.8% METHODS (burden 7.3 million) and 13.7% (burden 6.7 million) when The third national SuRFNCD in Iran, designed Correspondence to extrapolated to the Iranian population aged 15e64. The Dr Mehrshad Abassi, Endocrine based on the STEPwise guidelines of WHO, was Research Center, Valiasr prevalence of current and daily cigarette smoking was conducted in May 2007 and involved 5287 Iranian Hospital, Tehran University of 12.5% (6.1 million; 23.4% males and 1.4% females) and citizens.8 This survey was approved by the ethics Medical Sciences, Keshavarz 11.3% (5.6 million; 21.4 males and 1.4 females); former committee of the Center for Disease Management Blvd, Tehran 14197-33147, Iran; smokers comprised 1.7 million or 3.4% of the Iranian of Iran. The survey sampling was based on random http://tobaccocontrol.bmj.com/ [email protected] population (6.2% males and 0.6% females; mean clusters of 10 males and 10 females living in neigh- Received 2 April 2009 cessation age 34.1). The mean age of starting to smoke bouring households. The address of the first subject Accepted 18 November 2009 was 20.5 years (24.2 males and 20.4 females). The of each cluster was selected from the list of postal prevalence of water-pipe smoking was 2.7% (burden addresses of the Iran Post Company. The households 1.3 million; 3.5% males and 1.9% females). Water-pipe were approached based on a predetermined plan. smokers used the water-pipe on average 3.5 times a day Sampling was continued until 20 volunteers were (2.8 males and 4.5 females). registered. The study population included non- Conclusion The prevalence of tobacco use has not institutionalised Iranian citizens aged 15e64 years. escalated over the past two decades. Nonetheless, the The survey sample was selected proportional to burden is high and therefore warrants preventive public urban/rural population size of all 30 provinces of health policies. Iran. Participants were visited at their household by on October 2, 2021 by guest. Protected copyright. trained interviewers. Oral informed consent was obtained from participants. Tobacco use is one of the major preventable causes Interviewers administered questionnaires of premature death around the world.1 Ninety per containing six different domains: identification and cent of all lung cancers, 70% of chronic bronchitis demographic information, diet, physical activity, and emphysema and about 25% of ischaemic heart tobacco use, history of hypertension and history of events have been attributed to cigarette smoking.2 diabetes. The tobacco-related questions of the Among 4000 chemicals detected in tobacco smoke, STEPwise Approach to Chronic Disease Risk Factor 60 are known or suspected to be carcinogens.2 Surveillance are built on the WHO guidelines for According to the World Health Orgnization, tobacco use surveillance documents. In brief, tobacco use in the 20th century resulted in respondents were asked about current and daily use 100 million deaths worldwide. Approximately of any amount of any tobacco products including 5 million deaths a year are attributed to tobacco, cigarettes, pipes and water-pipes. Tobacco use by and this is projected to exceed one billion by the end pipe and ‘chopoq’, a smoking instrument similar to of 21st century.3 Approximately 70% of these a pipe, was addressed in one question. Current This paper is freely available deaths will occur in developing countries.4 cigarette smoking was defined as smoking any online under the BMJ Journals unlocked scheme, see http:// Developing nations embrace a disproportionate amount of any kind of factory-made cigarettes, tobaccocontrol.bmj.com/site/ share of the global tobacco burden (84% of all hand-made cigarettes or cigars at the time of the about/unlocked.xhtml current smokers), comprising 1.3 billion individ- interview. The ‘current cigarette smokers’ who Tobacco Control 2010;19:125e128. doi:10.1136/tc.2009.030759 125 Research paper Tob Control: first published as 10.1136/tc.2009.030759 on 11 December 2009. Downloaded from Table 1 Estimates of current and daily tobacco smoking, Iran, 2007 Current tobacco use Daily tobacco use Population Prevalence (95% Prevalence (95% Variable Subcategory size (’000s) Burden CI) Burden CI) Age 15e24 17710 1608050 9.1% (6.8 to 11.9) 1466850 8.3% (6.3 to 10.8) 25e34 12760 1833050 14.4% (11.6 to 17.7) 1706950 13.4% (10.7 to 16.6) 35e44 9000 2014100 22.4% (17.3 to 28.4) 1821900 20.2% (16.0 to 25.3) 45e54 6270 1314200 21.0% (17.1 to 25.4) 1277900 20.4% (16.6 to 24.8) 55e64 3350 501600 15.0% (12.0 to 18.5) 462750 13.8% (11.0 to 17.2) Sex Male 24840 6487000 26.1% (23.8 to 28.6) 6025000 24.3% (22.1 to 26.6) Female 24250 784000 3.2% (2.6 to 4.0) 711400 2.9% (2.4 to 3.6) Residential area Urban area 34520 5031000 14.6% (11.8 to 17.9) 4668250 13.5% (10.9 to 16.7) Rural area 14570 2240000 15.4% (10.1 to 22.7) 2068150 14.2% (9.5 to 20.6) TOTAL 49090 7271000 14.8% (12.2 to 17.9) 6736400 13.7% (11.3 to 16.5) smoked daily, were defined as ‘daily cigarette smokers’. Water- 14.8% overall, 26.1% for men and 3.2% among women (table 1). pipe and pipe/chopogh smokers were asked if they were daily Prevalence was highest among respondents aged 35e44 (22.4%). habits. All measures considering overlaps were summed to esti- The prevalence of current cigarette smoking was 12.5% (95% mate an overall prevalence of tobacco smoking. Respondents CI 10.0% to 15.6%), which corresponds to more than 6.1 million were also asked about history of daily use of any amount of Iranians aged 15e64 (table 2). The highest prevalence of current cigarettes and cigars. Smoking cessation was inferred from this cigarette smoking was in individuals aged 35e44 years (19.9%). variable and comprised subjects who had been smoking any type Males had much higher rates of current cigarette smoking than of cigarettes (factory-made cigarettes, hand-made cigarettes or females (23.4% (95% CI 21.2% to 25.8%) vs 1.4% (95% CI 1.0% cigars) earlier, but they didn’t smoke at the time of the study. to 2.0%); OR¼21.5 (95% CI 16.2 to 27.9)). Current cigarette Finally the extent and age of initiation and abstinence of tobacco smoking was found in 12.7% and 12.1% of residents in urban and product use were recorded if indicated. rural areas, respectively (OR ¼ 1.1 (95% CI 0.9 to 2.0)). About 90.5% of current smokers were daily smokers (11.3% of the total Statistical analysis adult population (95% CI 9.0% to 14.1%), representing 5 570 000 Complex sample survey analyses were performed by SPSS 16 for Iranians). Less than 5% of respondents (3.4%; 95% CI 2.7% to Windows. To extrapolate the results to the Iranian adult popu- 4.3%) were former smokers, representing 1 680 000 Iranians. The e lation, data were weighted directly to the 2006 population of prevalence of former smokers was highest in those aged 55 64 Iran aged $15 years and #64 years, based on the 2006 national (7.9%). Iranian census, to match the age (10-year strata), sex and area of In all, 2.7% (95% CI 2.2 to 3.4) or 1 341 000 Iranians were daily http://tobaccocontrol.bmj.com/ residence (rural/urban).
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