Smokeless tobacco use and its associated factors among secondary school students of Rangeli Municipality of Morang district, Nepal

• Published in: PloS one 2024-11, Vol.19 (11), p.e0313288
• Main Authors: Rajbanshi, Manish, Rajbanshi, Rocky, Aryal, Richa
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Age; Analysis; Asthma; Biology and Life Sciences; Cancer; Chewing tobacco; Chronic obstructive pulmonary disease; Communicable diseases; Confidence intervals; Cross-Sectional Studies; Data collection; Drug addiction; Drugs and youth; Education; Female; Health aspects; Health risks; High school students; High schools; Humans; Lung diseases; Male; Mean; Medicine and Health Sciences; Municipalities; Nepal - epidemiology; Oncology, Experimental; Organizations; People and Places; Population; Prevalence; Preventable deaths; Public health; Pulmonary functions; Questionnaires; Regression analysis; Respiratory diseases; Respiratory function; Respiratory tract diseases; Risk; Risk Factors; Sample size; Schools; Secondary school students; Secondary schools; Smokeless tobacco; Smoking; Social Sciences; Statistical analysis; Students; Students - statistics & numerical data; Surveys and Questionnaires; Teenagers; Tobacco; Tobacco Use - epidemiology; Tobacco, Smokeless - statistics & numerical data; Young Adult; Youth; Youth market
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0313288

The tobacco epidemic is one of the biggest public health threats and the world's leading cause of preventable death which is responsible for killing 8 million people every year. Adolescents are the vulnerable age group and are at greater risk of any tobacco use including smokeless tobacco (SLT) and nicotine addiction. Tobacco use at a young age increases the risk of various non-communicable diseases (NCDs) such as respiratory illness, asthma, chronic obstructive respiratory disease (COPD), reduced pulmonary function, and cancers. This study aimed to determine the prevalence of smokeless tobacco and its associated factors among secondary school students of grades 11 and 12 in Rangeli Municipality, Nepal. A cross-sectional study was conducted among 355 students from the selected secondary schools. A self-administered questionnaire was used to collect the data. Data was cleaned and then exported to IBM SPSS Statistics 20 for analysis. Participants' characteristics were described using frequencies, percentages, mean, and standard deviation. Multivariate logistic regression was conducted to determine the association between individual characteristics and prevalence of smokeless tobacco. All the tests were performed at a 95% Confidence Interval (CI) and a p-value less than 0.05. The mean (±SD) age of the participants was 18.0±1.3 years. Most participants were female (61.1%). The majority of the participants were from grade 11 (58.3%), government schools (60%), and nuclear families (64.8%). This study found that 38.4% and 61.6% of the participants were SLT ever users and never users respectively. Among the ever users, 29.5% were current users and most tried (47.7%) at the age of 10-14 years. Most participants revealed that homes and public places were common sites for SLT use. Paan Masala and Gutkha were the most commonly preferrable SLTs. This study found that age (AOR = 1.5, CI: 1.2-2.2), sex (AOR = 2.6, CI:1.6-4.4), and school type (AOR = 1.8, CI:1.1-3.0) were significantly associated with the prevalence of SLT. This study found that the prevalence of current SLT users is higher than the national survey. This study concludes that males, young adolescents, and students from private schools are at greater risk of SLT use and are unaware of the consequences on their health. Concerned stakeholders must expand awareness and promote educational programs on the harmful use of tobacco targeting secondary school students. The government organizations, educational insti