Displaying all 3 publications

Abstract:
Sort:
  1. Tan QY, Zomer E, Owen AJ, Chin KL, Liew D
    Tob Control, 2020 01;29(1):111-117.
    PMID: 30610080 DOI: 10.1136/tobaccocontrol-2018-054677
    BACKGROUND: The loss of productivity arising from tobacco use in low/middle-income countries has not been well described. We sought to examine the impact of cigarette smoking on population health and work productivity in Malaysia using a recently published measure, the productivity-adjusted life year (PALY).

    METHODS: A life table model was constructed using published Malaysian demographic and mortality data. Our analysis was limited to male smokers due to the low smoking prevalence in females (1.1%). Male smokers aged 15-64 years were followed up until 65 years or until death. The population attributable risk, health-related quality of life decrements and relative reduction in productivity due to smoking were sourced from published data. The analysis was repeated assuming the cohorts were never smokers, and the differences in outcomes represented the health and productivity burden conferred by smoking. The cost of productivity loss was estimated based on the gross domestic product per equivalent full-time worker in Malaysia.

    RESULTS: Tobacco use is highly prevalent among working-age males in Malaysia, with 4.2 million (37.5%) daily smokers among men aged between 15 and 64 years. Overall, our model estimated that smoking resulted in the loss of over 2.1 million life years (2.9%), 5.5 million (8.2%) quality-adjusted life years (QALYs) and 3.0 million (4.8%) PALYs. Smoking was estimated to incur RM275.3 billion (US$69.4 billion) in loss of productivity.

    CONCLUSION: Tobacco use imposes a significant public health and economic burden among working-age males in Malaysia. This study highlights the need of effective public health interventions to reduce tobacco use.

    Matched MeSH terms: Tobacco Use/economics*
  2. Sreeramareddy CT, Ramakrishnareddy N
    BMC Public Health, 2017 07 24;18(1):48.
    PMID: 28738826 DOI: 10.1186/s12889-017-4579-y
    BACKGROUND: Food insecurity is a very common problem in developing countries particularly among the poorer households. Very few studies have tested the association between adult smoking and food insecurity.

    METHODS: We analysed the data from a nationally representative sample of 10,826 households in which women and men (in a sub sample of 4121 households) aged 15-49 years were interviewed in Nepal Demographic and Health Survey 2011. Data from households in which both men and women were interviewed were analysed for association of household food insecurity access score (HFIAS), with tobacco use among men and women, socio-demographic and spatial factors. Univariate comparisons followed by zero-inflated negative binomial regression analyses were done to determine the association between HFIAS and individual, household and spatial factors.

    RESULTS: Mean HFIAS score was 3.5 (SD, 4.6) whereas the median was 0 (IQR 0-6). Prevalence of tobacco use among men and women was 50.2% (95% CIs 47.9, 52.6), and 17.3% (95% CIs 15.7, 18.9). HFIAS scores were significantly higher among households where men used tobacco (4.96), and men either smoked or use SLT (3.82) as compared to those without tobacco users (2.79). HFIAS scores were not significantly different by tobacco use status of women. HFIAS score was highest in the poorest households and vice versa. After adjusting for covariates association between HFIAS score and male tobacco use remained significant but effect size decreased when covariates were included into regression models (adjusted OR 1.11). HFIAS score was also associated wealth index (adjusted OR 0.86-0.62) and ecological region (adjusted OR 1.33) and development regions (adjusted OR 1.10-1.21).

    CONCLUSION: Tobacco users in poor(er) households should be encouraged to 'quit' their habit. Less affluent sectors of the population also need to be educated about the non-health benefits of quitting, such as improved economic status and reduced food insecurity.
    Matched MeSH terms: Tobacco Use/economics*
  3. Sreeramareddy CT, Harper S, Ernstsen L
    Tob Control, 2018 01;27(1):26-34.
    PMID: 27885168 DOI: 10.1136/tobaccocontrol-2016-053266
    BACKGROUND: Socioeconomic differentials of tobacco smoking in high-income countries are well described. However, studies to support health policies and place monitoring systems to tackle socioeconomic inequalities in smoking and smokeless tobacco use common in low-and-middle-income countries (LMICs) are seldom reported. We aimed to describe, sex-wise, educational and wealth-related inequalities in tobacco use in LMICs.

    METHODS: We analysed Demographic and Health Survey data on tobacco use collected from large nationally representative samples of men and women in 54 LMICs. We estimated the weighted prevalence of any current tobacco use (including smokeless tobacco) in each country for 4 educational groups and 4 wealth groups. We calculated absolute and relative measures of inequality, that is, the slope index of inequality (SII) and relative index of inequality (RII), which take into account the distribution of prevalence across all education and wealth groups and account for population size. We also calculated the aggregate SII and RII for low-income (LIC), lower-middle-income (lMIC) and upper-middle-income (uMIC) countries as per World Bank classification.

    FINDINGS: Male tobacco use was highest in Bangladesh (70.3%) and lowest in Sao Tome (7.4%), whereas female tobacco use was highest in Madagascar (21%) and lowest in Tajikistan (0.22%). Among men, educational inequalities varied widely between countries, but aggregate RII and SII showed an inverse trend by country wealth groups. RII was 3.61 (95% CI 2.83 to 4.61) in LICs, 1.99 (95% CI 1.66 to 2.38) in lMIC and 1.82 (95% CI 1.24 to 2.67) in uMIC. Wealth inequalities among men varied less between countries, but RII and SII showed an inverse pattern where RII was 2.43 (95% CI 2.05 to 2.88) in LICs, 1.84 (95% CI 1.54 to 2.21) in lMICs and 1.67 (95% CI 1.15 to 2.42) in uMICs. For educational inequalities among women, the RII varied much more than SII varied between the countries, and the aggregate RII was 14.49 (95% CI 8.87 to 23.68) in LICs, 3.05 (95% CI 1.44 to 6.47) in lMIC and 1.58 (95% CI 0.33 to 7.56) in uMIC. Wealth inequalities among women showed a pattern similar to that of men: the RII was 5.88 (95% CI 3.91 to 8.85) in LICs, 1.76 (95% CI 0.80 to 3.85) in lMIC and 0.39 (95% CI 0.09 to 1.64) in uMIC. In contrast to men, among women, the SII was pro-rich (higher smoking among the more advantaged) in 13 of the 52 countries (7 of 23 lMIC and 5 of 7 uMIC).

    INTERPRETATION: Our results confirm that socioeconomic inequalities tobacco use exist in LMIC, varied widely between the countries and were much wider in the lowest income countries. These findings are important for better understanding and tackling of socioeconomic inequalities in health in LMIC.

    Matched MeSH terms: Tobacco Use/economics
Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links