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Prevalence, pattern and sociodemographic differentials in smokeless tobacco consumption in Bangladesh: evidence from a population-based cross-sectional study in Chakaria
  1. Mohammad Nahid Mia1,
  2. S M A Hanifi1,
  3. M Shafiqur Rahman2,
  4. Amena Sultana1,
  5. Shahidul Hoque1,
  6. Abbas Bhuiya1,3
  1. 1Health Systems and Population Studies Division (HSPSD), International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka, Bangladesh
  2. 2Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
  3. 3Future Institute, Dhaka, Bangladesh
  1. Correspondence to Mohammad Nahid Mia; nahid{at}


Background The health hazards associated with the use of smokeless tobacco (SLT) are similar to those of smoking. However, unlike smoking, limited initiatives have been taken to control the use of SLT, despite its widespread use in South and Southeast Asian countries including Bangladesh. It is therefore important to examine the prevalence of SLT use and its social determinants for designing appropriate strategies and programmes to control its use.

Objective To investigate the use of SLT in terms of prevalence, pattern and sociodemographic differentials in a rural area of Bangladesh.

Design Population-based cross-sectional household survey.

Setting and participants A total of 6178 individuals aged ≥13 years from 1753 households under the Chakaria HDSS area were interviewed during October–November 2011.

Methods The current use of SLT, namely sadapatha (dried tobacco leaves) and zarda (industrially processed leaves), was used as the outcome variable. The crude and net associations between the sociodemographic characteristics of respondents and the outcome variables were examined using cross-tabular and multivariable logistic regression analysis, respectively.

Results 23% of the total respondents (men: 27.0%, women: 19.3%) used any form of SLT. Of the respondents, 10.4% used only sadapatha,13.6% used only zarda and 2.2% used both. SLT use was significantly higher among men, older people, illiterate, ever married, day labourers and relatively poorer respondents. The odds of being a sadapatha user were 3.5-fold greater for women than for men and the odds of being a zarda user were 3.6-fold greater for men than for women.

Conclusions The prevalence of SLT use was high in the study area and was higher among socioeconomically disadvantaged groups. The limitation of the existing regulatory measures for controlling the use of non-industrial SLT products should be understood and discussion for developing new strategies should be a priority.

  • Smokeless tobacco
  • Sadapatha (Tobacco leaf)
  • Zarda
  • Sex-differentials
  • Chakaria, Bangladesh

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors AB, SyH, MNM, MSR, AS and ShH conceived and designed the experiments. SyH, MNM and ShH performed the experiments. AB, SyH, MNM and MSR analysed the data. AB, SyH, MNM, MSR, AS and ShH wrote the paper.

  • Funding ICDDR,B Core Donors: Government of the People's Republic of Bangladesh; Global Affairs Canada (GAC); Swedish International Development Cooperation Agency (Sida) and the Department for International Development (UK Aid).

  • Competing interests None declared.

  • Ethics approval Ethical Review Committee of ICDDR,B.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The authors confirm that all data underlying the findings are fully available without restriction. All data underlying the findings in this paper are freely available upon request subject to the adherence to ICDDR,B data sharing policy( The request for the data can be sent to, the principal investigator of the project.

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