Determinants of tobacco smoking among presumptive TB patients in Taungoo Township, Myanmar

Abstract

A hospital-based cross-sectional study was conducted in Taungoo Township, Myanmar to examine prevalence and determinants of current tobacco smokers among presumptive TB patients aged 18 years and above. A total of 400 presumptive TB patients which was drawn by purposive sampling were face-to-face interviewed using a structured questionnaire in April, 2017. The questionnaire had three parts: socio-demographic factors, socio-environmental factors and psycho-social factors based on social cognitive theory. Harmful alcohol drinking and mental distress were measured by using Alcohol Use Disorders Identification Test (AUDIT-C) and Kessler Psychological Distress Scale (K-10), respectively. Current tobacco smokers, the outcome measure were identified based on questionnaires of Global Adult Tobacco Survey (GATS). Chi-square test and multiple logistic regression were used to examine determinants of tobacco smoking.

Prevalence of current tobacco smokers was 54%. In multiple logistic regression, factors significantly associated with tobacco smoking were sex(Adj OR=4.65, 95%CI=2.14-10.12 for men compared to women), education levels (Adj OR=3.89, 95%CI=1.19-12.65 for middle or high school and Adj OR=4.39, 95%CI=1.22-15.77 for primary school or less compared to college or university), income (Adj OR=3.05, 95%CI=1.42-6.54 for middle income compared to low income), marital status (Adj OR=1.97, 95%CI=1.01-3.81 for living without a spouse compared to living with a spouse), harmful alcohol drinking(Adj OR=3.42, 95%CI=1.77-6.60), mental distress (Adj OR=2.97, 95%CI=1.12-7.89), and knowledge about smoking hazards(Adj OR=4.94, 95%CI=2.49-9.76 for middle level, and Adj OR=6.50, 95%CI=2.45-17.24 for low level compared to high level).

This study showed one in two presumptive TB patients were current smokers. Current smokers were particularly male, from low socioeconomic status and had poor knowledge, lived alone, drank alcohol, and had mental distress. This could help policy makers to identify people at risk of negative health outcomes of diseases, and promote the tobacco cessation services with integrated alcohol intervention in health facilities as a component of TB program in Myanmar.