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Indian J Cancer. 2014 Dec;51 Suppl 1:S73-7. doi: 10.4103/0019-509X.147477.

Smokeless tobacco use: a meta-analysis of risk and attributable mortality estimates for India.

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1
World Health Organization, Regional Office for South-East Asia, New Delhi, India.

Abstract

BACKGROUND:

Use of smokeless tobacco (SLT) is widely prevalent in India and Indian subcontinent. Cohort and case-control studies in India and elsewhere report excess mortality due to its use.

OBJECTIVE:

The aim was to estimate the SLT use-attributable deaths in males and females, aged 35 years and older, in India.

MATERIALS AND METHODS:

Prevalence of SLT use in persons aged 35 years and older was obtained from the Global Adult Tobacco Survey in India and population size and deaths in the relevant age-sex groups were obtained from UN estimates (2010 revision) for 2008. A meta-relative risk (RR) based population attributable fraction was used to estimate attributable deaths in persons aged 35 years and older. A random effects model was used in the meta-analysis on all-cause mortality from SLT use in India including four cohort and one case-control study. The studies included in the meta-analysis were adjusted for smoking, age and education.

RESULTS:

The prevalence of SLT use in India was 25.2% for men and 24.5% for women aged 35 years and older. RRs for females and males were 1.34 (1.27-1.42) and 1.17 (1.05-1.42), respectively. The number of deaths attributable to SLT use in India is estimated to be 368127 (217,076 women and 151,051 men), with nearly three-fifth (60%) of these deaths occurring among women.

CONCLUSION:

SLT use caused over 350,000 deaths in India in 2010, and nearly three-fifth of SLT use-attributable deaths were among women in India. This calls for targeted public health intervention focusing on SLT products especially among women.

PMID:
25526253
DOI:
10.4103/0019-509X.147477
[Indexed for MEDLINE]
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