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A cross country comparison of tobacco use among youth between Yerevan and New Delhi

A cross country comparison of tobacco use among youth between Yerevan and New Delhi

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    Final master proj presentation with hyren dp (1) Final master proj presentation with hyren dp (1) Presentation Transcript

    • A cross country comparison of tobacco use among youth in Yerevan (Armenia) and New Delhi (India)
      Student Investigator: Neeraj Kishore Pandey, MD, MPH (c)
      Advisor: Byron Crape, MSPH, PhD
      Reader : NarineMovsisyan, MD, MPH
      Diana Petrosyan, MD, MPH
      1
    • Outline
      Introduction
      Methods
      Results
      Discussion
      Conclusion
      Recommendations
      2
    • Public health problem of tobacco use
      One of major preventable causes of death.
      Morbidity and mortality:
      Lung cancer, CVD, COPD, atherosclerosis.
      Over 4 millions die each year due to smoking
      1 death due to smoking every 8 seconds globally.
      Economic impact on family:
      Smoking diverts money from basic needs.
      WHO, 2002
      3
    • Situation in Armenia
      Major public health problem, with a greater impact on urban areas.
      Smoking rates among Armenian men one of the highest globally.
      Smoking rates: male-60%, female-2% (age group -16 years and above), 2005.
      National survey on Drug, Alcohol and smoking prevalence among general population of Armenia, 2005
      4
    • Situation in India
      Smoking is responsible for half of cancers in men and a quarter of cancers in women
      WHO projects tobacco deaths may exceed 1.5 million by 2020 in India.
      Smoking rates: male-57%, female-11% (age group -15 to 54 years), 2005-2006.
      National Family Health Survey, India,2005-2006
      5
    • Rationale for study
      High smoking rates in Armenia and India.
      No other comparative study conducted for these two countries
      Finding common and different risk factors and protective factors associated with tobacco use between the two cities will inform and strengthen tobacco control programs.
      6
    • Research question: 1
      What are the differences and similarities between smoking practices, beliefs and attitudes of school- based students 11 to 17 years of age in Yerevan, Armenia and New Delhi, India ?
      7
    • Research question: 2
      What are the differences and similarities between students’ familial and environmental factors influencing smoking among youth in school 11 to 17 years of age between Yerevan, Armenia and New Delhi, India?
      8
    • Research question: 3
      What are the differences and similarities in risk factors associated with initiation of smoking among youth in school 11 to 17 years of age between Yerevan, Armenia and New Delhi, India?
      9
    • Global Youth Tobacco Survey (GYTS)
      School-based surveys conducted globally
      Collected data from students13 to 15 years of age
      Used standardized methodology to construct sampling frame, randomized methods to select schools and classes for sampling and data processing
      10
    • 11
      Methods
      Secondary data analysis
      Datasets and codebooks
      GYTS 2001 New Delhi, India (N=12086)
      GYTS 2004 Yerevan, Armenia (N=560)
      Sources
      WHO website
      Coordinator of the state tobacco control program in Armenia
      11
    • 12
      Methods
      • Data analysis
      • SPSS 11 software
      • Code book of 32 questions created
      • 69 questions for India
      • 91 questions for Armenia
    • Results: Bivariate analysis
      13
    • Regular smoking prevalence rate by gender and city
      14
      Percent
      P<0.001
    • Regular smoking prevalence rates among student by age group, stratified by city
      Age Groups in Years
      P<0.001
    • Percentage of students who reported definitely or probably smoke or not smoke a cigarette if their best friend offered them a cigarette
      16
      P<0.001
    • Final multivariate logistic regression with city of residence (New Delhi vs. Yerevan) as the outcome and smoking risk factors as covariates
      17
    • Final multivariate logistic regression with regular smoking vs. non-regular smoking as the outcome, city of residence (New Delhi vs. Yerevan) and smoking risk factors as covariates
      18
    • Discussion
      Female students more likely to take up regular smoking in New Delhi than in Yerevan
      Regular smoking rates were higher in the earlier ages in New Delhi and were higher in later ages in Yerevan.
      Rates of increase in smoking rates over age higher in Yerevan than Delhi.
      19
    • Discussion
      Fathers almost twice as likely to be smokers in Yerevan than in New Delhi.
      Students in Yerevan twenty times more likely to accept and smoke a cigarette offered by their best friend than in New Delhi.
      Anti-smoking references seen on posters and in newspapers and magazines were more frequently seen by non-regular smokers than regular smokers.
      20
    • Limitations
      There were too few girls who smoked to analyze them separately from boys
      Because of lack of matches between the instruments, some questions were dropped out
      21
    • Strengths
      Large sample size of New Delhi and adequate sample size of Yerevan
      Surveys conducted only three year apart (2001 and 2004).
      Surveys conducted prior to law banning tobacco advertising in both the cities.
      22
    • Conclusions
      Smoking fathers and peer pressure are associated with increased risk of student smoking.
      Family members discussing harmful effects of tobacco is substantially associated with reduced risk of smoking.
      Unknown and unmeasured cultural and environmental factors different between the two cities associated with smoking
      23
    • Recommendations
      Smoking fathers and peer pressure in Armenia should be especially targeted for more effective anti-tobacco campaign
      Family members included in anti-smoking programs to prepare them to discuss harmful effects of smoking.
      More comparative studies needed to further explore unknown and unmeasured cultural/environmental factors.
      24
    • ԴեռահասներիշրջանումծխախոտիօգտագործմանհամեմատությունըԵրևանում (Հայաստան) և ՆորԴելիում (Հնդկաստան)
      25
    • ԱՌԱՋԱՐԿՈՒԹՅՈՒՆՆԵՐ
      Դեռահասներիշրջանումհակածխախոտայինծրագրերըավելիարդյունավետդարձնելունպատակովառաջարկումենք`
      առանձնահատուկուշադրությունդարձնելայնպիսիգործոնների, ինչպիսիննենհործխելը և հասակակիցներիճնշումը
      ընդգրկելընտանիքիանդամներին` ուսուցանելունրանցքննարկելդեռահասներիհետ ծխախոտիօգտագործմանվնասակարազդեցությունները
      Իրականացնելհետագահամեմատականհետազոտություններ` ուսումնասիրելուդեռևսչբացահայտված և չգնահատվածմշակութայինգործոններիազդեցությունըդեռահասներիշրջանումծխախոտիօգտագործմանվրա
      26
    • Thank You
      27
    • Questions?
      28