Prevailing familial, social and cultural obstacles in keeping tobacco-free homes in urban areas of Bangladesh: A mixed-method study
Md. Imdadul Haque1, ABM Alauddin Chowdhury1, Muhammad Shaikh Hassan2, Hafiz T. A. Khan3, Md. Golam Dostogir Harun1,
1 Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University,
Dhanmondi, Dhaka, Bangladesh, 2 Center of Excellence for Health Systems and Universal Health Coverage,
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh, 3 The Graduate
School, University of West London, London, United Kingdom
Millions of children and others across the world are being dangerously exposed to tobacco smoke and toxins in their own homes. Whilst there is limited interest in laws and interventions controlling tobacco use in public places in Bangladesh, no attention has been given to
preventing tobacco-use inside homes. This study explores the familial and socio-cultural factors that provide obstacles for ensuring tobacco-free homes in Bangladesh.
Materials and methods
A mixed-method design was adopted and from among the 1,436 tobacco users identified in a population of 11,853, 400 (tobacco users) were selected for cross-sectional survey. This survey involved a probability proportional sampling procedure, and 24 In-Depth Interviews. Multivariate logistic regression was performed to explore the association of familial and socio-cultural factors with tobacco use at home adjusted by other demographic characteristics. Thematic content analysis was done on the qualitative data, and then inferences were drawn out collectively.
This study revealed that the prevalence of tobacco-use in the home was 25.7% in urban residential areas in Bangladesh. Multivariate logistic regression analysis identified that familial and socio-cultural factors were significantly associated with tobacco-use at home: marital status (OR 3.23, 95% CI: 1.37–6.61), education (OR 2.14, 95% CI: 1.15–3.99), smoking habits of older family members (OR 1.81 95% CI: 0.91–2.89), tobacco being offered as hospitality and for entertainment (OR 1.85, 95% CI: .94–2.95) and lack of religiosity practice (OR 2.39, 95% CI: 1.27–4.54). Qualitative findings indicated that social customs, lack of religious practice, tobacco-use of older family members, and lack of family guidance were key obstacles for enabling tobacco-free homes in urban areas.
Use of tobacco at home is continuing as part of established familial and socio-cultural traditions.
If tobacco-use at home is not addressed seriously by the authorities then the emerging
threat of second-hand smoke exposure and harmful consequences of tobacco- use will be
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