TOBACCO CESSATION COUNSELLING FOR WOMEN IN RURAL SINDH: IS IT BEING OFFERED?
AbstractBackground: Tobacco is the single leading and most preventable cause of death in today’s worlds andresponsible for six of the eight leading mortality causes in the world. Diseases related to tobacco use areknown to cause about 5.4 million deaths every year, 80% of which are contributed by the developingworld, and this toll is estimated to increase up to 8 million deaths per year by 2030. This study wasconducted to determine the number of women who were offered counselling regarding cessation oftobacco use by all health care providers (medical and alternate), in rural Sindh, Pakistan. Methods:This cross-sectional survey was conducted during January to March, 2008 in District Khairpur, Sindh,Pakistan. A validated, pre-tested, translated questionnaire was used to collect the data from 502, adultwomen (aged between 18–60 years). These women were asked about the type of health provider theyvisited in the past 12 months and practices of provider regarding tobacco control including cessationand advice. Results: A large majority of women (nearly 71%) were illiterate, and 44% of women werein the age group 18–24 years. High prevalence (10%) of adult women were smokers. Only 12% of thetotal women who visited physicians during this time period were asked about their smoking status ascompared to 7% who visited hakims and 13% who were approached by lady health visitors.Conclusion: A very small segment of the women users of health care system is enquired andcounselled about tobacco use in any form by the health providers in Rural Sindh. Revisiting practicesfor health care professionals is urgently needed to address inevitable tobacco use in the region.Keywords: Tobacco, Women, Pakistan, Health Care Provider, Smoking, Control, Rural Sindh
Wipfli H, Samet JM. Global economic and health benefits of
tobacco control: part-1. Clin Pharmacol Ther 2009;86:263–71.
World Health Organization. The World Health Report on the
Global Tobacco Epidemic. The MPOWER Package. Geneva:
Human Development Report 2006, United Nations Development
Pakistan Census Organization. Population census report.
Government of Pakistan Islamabad: 2000.
Ali S, Sathiakumar N, Delzell E. Prevalence and sociodemographic factors associated with tobacco smoking among
adult males in rural Sindh, Pakistan. Southeast Asian J Trop Med
Public Health 2006;37:1054–60.
Ali S, Ara N, Ali A, Ali B, Kadir MM. Knowledge and practices
regarding cigarette smoking among adult women in a rural
district of Sindhh, Pakistan. J Pak Med Assoc 2008;8:664–7.
Nisar N, Billoo N, Gadit A A. Pattern of tobacco consumption
among adult women of low socioeconomic community Karachi
Pakistan. J Pak Med Assoc 2005;55(3):111–4.
Nisar N, Qadri MH, Fatima K, Perveen S. A community based
study about knowledge and practices regarding tobacco
consumption and passive smoking in Gadap Town, Karachi. J
Pak Med Assoc 2007;57:186–8.
Ali NS, Khuwaja AK, Ali T, Hameed R. Smokeless tobacco use
among adult patients who visited family practice clinics in
Karachi, Pakistan. J Oral Pathol Med 2009;38:416–21.
West R, McNeill A, Raw M. Smoking cessation guidelines for
health professionals: an update. Thorax 2000;55:987–99.
McIvor A, Kayser J, Assaad JM, Brosky G, Demarest
P, Desmarais P, et al. Best practices for smoking cessation
interventions in primary care. Can Respir J. 2009;16(4):129–34.
Lancaster T, Stead L, Silagy C, Sowden A. Effectiveness of
interventions to help people stop smoking: findings from the
Cochrane Library. BMJ 2000;321:355–8.
Gorin SS, Heck JE. Meta-analysis of the efficacy of tobacco
counseling by health care providers. Cancer Epidemiol
Biomarkers Prev 2004;13:2012–22.
Anderson JE, Jorenby DE, Scott WJ, Fiore MC. Treating tobacco
use and dependence: an evidence-based clinical practice
guideline for tobacco cessation. Chest 2002;121:932–41.
Kreuter M W, Chheda S G, Bull FC. How does physician advice
influence patient behaviour? Evidence for a priming effect. Arch
Fam Med 2000;9:426–33.
Kottke TE, Battista RN, DeFriese GH, Brekke ML. Attributions
of successful smoking cessation interventions in medical
practice: a meta analysis of 39 controlled trials. JAMA
Planning and Development Department. Government of Sindhh.
Population Census Report, District Khairpur: Karachi: 2000.
Alam AY, Iqbal A, Mohamud KB, Laporte RE, Ahmed
A, Nishtar S. Investigating socio-economic-demographic
determinants of tobacco use in Rawalpindi, Pakistan. BMC
Public Health 2008;8:50.
Surgeon General’s Report. Women and Smoking. A report of the
Surgeon General-2001. CDC Publication: 2001.
Global Youth Tobacco Survey Collaborating Group. Differences
in Worldwide Tobacco Use by Gender: Findings from the Global
Youth Tobacco Survey. J Sch Health 2003,73(6):207–15.
The Health consequences of Smoking: A report of Surgeon
General. US. Department of Health and Human Services, Centers
for Disease Control and Prevention, National Centre for Chronic
Disease Prevention and Health Promotion, Office on Smoking
and Health, Washington, DC: 2004.
Hopkinson JM, Schanler RJ, Fraley JK, Garza C. Milk
production by mothers of premature infants: influence of
cigarette smoking. Pediatrics, 1992;90:934–8.
World Health Organization: The Role of Health Professionals in
Tobacco Control. Available at: http://paho.org/English/DD/PUB/
Eckert T, Junker C. Motivation for Smoking Cessation: What
role do doctors play? Swiss Med Wly 2001;131:521–6.
Mumtaz R, Khan AA, Moeen F, Noor N, Humayun S. The role
of Pakistani dentists in tobacco cessation. Int Dent
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