An epidemiological study of Profiles of Smoker's

 

John Masih¹*, Sanjay Kumar², Deepak Kumar²

¹Associate Professor, Medicine, Late BRKM Govt. Medical College, Jagdalpur

²Assistant Professor, Medicine, Late BRKM Govt. Medical College, Jagdalpur

 

ABSTRACT:

Background: Cigarette consumption is increasing among adolescents and young adults. Most of Indian smokers don't know that their tobacco addiction is jeopardizing their health so much so that if they don't make themselves free from this habit they may fall in the grip of serious and chronic diseases like cancer, heart attack etc. Objective: To analysis the epidemiological profile of smokers Material and Method: A questionnaire covering various variables like sampled client's age, sex, diet pattern, alcohol habits, Random Blood Sugar status etc. was developed for collection of data, which was pre, tested before introduction among sampled persons. The data thus collected were analyzed, tabulated and inferences were drawn. Findings and Discussion: It has been found that male smokers outnumbered female smokers. Female smokers belong to 71 +years of age group while males belong to all age group. More than 50 % smokers found obese similarly more than 50 % persons found either in pre-hypertensive or hypertensive stage. Conclusion and recommendations: As tobacco consuming comes under modifiable risk factor, it will be better to conduct an intensified campaign, using all available media for bringing awareness in the community about various hazardous effect of tobacco.

 

 

 

INTRODUCTION:

Cigarette smoking constitutes the single most modifiable risk factors to Coronary Artery Diseases (CAD) and is one of the reading preventable cause of death. The rate of tobacco consumption is increasing day by day amongst adolescents and young adults. Studies suggest that who consume 20 or more cigarettes daily have two fold or three-fold increase in cholesterol level and effects also depend on dose. Epidemiological studies in India confirm that smoking is an independent risk for hypertension and CAD.

 

According to Gupta (1, 2 and 3), tobacco causes 2.5 million preventable deaths per year worldwide that has increase more than tenfold since 1950. It has been projected that at present rates of consumption and global annual mortality from tobacco will rise to 33.00 million during the 1990's and to 19 million in 1020's.Howard et al(4)smoking affects atherothrombosis by several mechanisms. In addition to accelerating atherosclerotic progression, long term smoking may enhance oxidation of LDL-C and reduce level of HDL-C. Smoking also impairs endothelium dependent coronary vasodilatation, causes spontaneous platelet aggregation and increases monocyte adhesion to endothelial cells. Willett W.C.et al(5) reported that consumption of as few as one to four cigarettes daily increases CAD risks. By keeping in mind the above facts and as per recommendations of the World Health Organization (W.H.O.) study group in 1957, that in order to get a comprehensive picture of a health problem / disease, more and more studies about the same have to be conducted, Garg Narenra K.(6) and Garg Narenra K. and Sharma A.B.(7), the authors have under taken this study with the objective to study the epidemiological profile of Smokers.

 

MATERIAL AND METHODS:

This is a retrospective study, carried out in the Medicine department of Govt.Medical College, Raipur between May 2003 and May 2004.A total of fifty smokers were included in study of all age group and both sexes were taken as sample. The data were collected in a pre-drawn and pre-tested questionnaire. The variables include the samples persons, age, gender, dietary habit and Alcohol consumption habit if any, Body Mass Index (BMI), Random Blood Sugar level (RBS), Blood Pressure (B.P.) etc.

 

TABLE-I. Diabetic and non - diabetic Smokers as per their age and gender n=50

	Age and Gender												Total
	31-40		41-50		51-60		61-70			71and above
	M	F	M	F	M	F		M	F		M	F
Diabetic-smokers	02	00	05	00	06	00		09	02		03	00	27
Non-diabetic - smokers	05	00	04	00	09	00		03	01		01	00	23
Total	07	00	09	00	15	00		12	03		04	00	50

 

FINDINGS AND DISCUSSION:

On analysis of collecting data, it has been revealed that there were more male smokers in comparison to females, similarly there were more diabetic smokers belonging to both sexes. It indicates that smoking play an important role as a predisposing factor, which is modifiable, in causing Diabetes. It was further found that male smokers belong to all age groups and their number goes up as age advances while female smokers belong to 71 +years of age group (Table-I).

 

TABLE – II. Smokers as per their dietary habit

	Non-vegetarian	Vegetarian
Male	46	01
Female	02	01
Total	48	02

 

(Table-II), shows that most of the sampled participants were non –vegetarian. On further analysis, it has been revealed that 33.00 % women participants were vegetarian in comparison to only 2.14 % males. There are people who thinks meat is "macho" (8).The study, published in the journal of consumer research, found that people's choices are influenced by a strong link of meat with masculinity – a reason why men generally are reluctant to try vegetarian products.

 

"To the strong, traditional, macho, bicep-flexing, All-American male, red meat is a strong, traditional, macho, bicep-flexing food", the researcher said." Soy is not. To eat it, they would have to give up a food as strong and powerful like themselves for a food they saw as weak and wimpy" they said. In a number of experiments, researchers from University of Pennsylvanis, Louisiana state University, University of north Carolina and Cornell University studied people's metaphors about certain foods. They also found that meat generated more masculine words when discussed, and that people viewed male meat eaters as being more masculine than non-meat eaters (8).

 

There were 48 % male smokers were alcoholic and equal proportion non-alcoholics in comparisons to 100 % females smokers were non-alcoholics. More diabetic smokers found obese in comparison to non diabetics (Table-III) among both sexes. There were 42 % each smokers belong to Normal BMI i.e.

 

TABLE-III. Smokers as per their BMI                               n=50

 

TABLE-IV. Diabetic and non-diabetic Smokers as per their Blood Pressure

 

 

 

Table—V. Smokers as per their Gender and Random blood Sugar (RBS) level

Gender	Random blood Sugar level
	Group –I (<160mg/dl)	Group-II  (160– 200mg/dl)	Group –III (>200mg/dl)	Total
Male	16	11	20	47
Female	00	01	02	03
Total	16	12	22	50

 

18.5-24.9 and overweight category i.e.25-29.9, thus it has been further observed that all 84 % in both category were males. 10 % and 06 % males and females respectively found Class-I i.e. 30-34.9 while none of the smokers belong to class –II and III.., as per Mittal S.R. et al (9) classification of Obesity. This also indicate that there is some co-relation between smoking, obesity and diabetes, which needs further research. (Table-IV) reveals that there were only 12 % persons belong to normotensive category of B.P., while 34 % in pre-hypertensive stage who at any moment can become hypertensive if they didn't de-addict themselves from the habit of smoking, and the rest 54 % belong to Stage –I and II of hypertension. On further analysis it has been revealed that this state of affairs was more or less, prevalent in both diabetic non diabetic smokers.

 

Table-V, reveals that on investigation of RBS level, 32 %males belong to Group-I in comparison to none of their female counterparts. 22 % males and 2 % females respectively belong to group-II and the remaining 44 % (40 % males and 4 % females) belong to Group-III.

 

Smoking is eight times more prevalent among Indian men than women. However, an average Indian female smoker puffs more cigarettes a day i.e.7 than males i.e.6.1.Over one in five (21%) Indian male tobacco users smoke daily as against only 3% of women. Nearly half of Indian men (47.9%) aged 15 years and above consume tobacco. Nearly 206 million Indians use smokeless form of tobacco (loose-leaf chewing tobacco and snuff).

 

Smokeless tobacco use is high among Indian men at 32.9%.One in every five female tobacco users in India uses the smokeless form as against one in ten who smoke. Also, an average Indian women is taking up smoking at 17.5 years as against 18.8 years among men. These are the new estimates of global tobacco use, published in the medical Journal, The Lancet on August 17, 2012 (10).An average Indian smoker smokes two cigarettes a day. For men, smoking of Bidis was common at 16.1%.The percentage of men who use both smoked and smokeless products was second highest in India at 9.3%.Overall, the number of tobacco users was highest in China (300.8 million) followed by India (274.9 million).India also had the most smokeless tobacco users (205.9 million).The quit rate was low in India with less than 20% of adults who had ever smoked saying they had given up. China, Egypt, Bangladesh and Russia, too, have poor quit rates. Quit ratio were found to be highest in the UK, the US, Brazil and Uruguay-with over 35% smokers saying they had stopped. Dr.K Srinath Reddy, president of Public Health Foundation of India, said "while tobacco use among men has dipped from 51 to 48%, it has gone up among females from 10 % to 20%.Women and girls are the new target of tobacco companies (10).Increase of tobacco use among women are alarming". The new estimates illustrate the epidemic of tobacco use for over half of world's population (representing more than three billion adults living in the UK, USA, and 14 developing countries including India), with around 852 million tobacco consumers. The new research reveals alarming patterns of tobacco use even after several years of global tobacco control efforts, with nearly of adult men in developing countries still using tobacco products, women increasingly starting to smoke at younger ages and low quit rates in most countries.

 

"Although 1.1 billion people have been covered by the adoption of the most effective tobacco-control policy since 2008, 83 % of the world's population are not covered by two or more of these policies, " said Gary Giovino from the university at Buffalo School of Public Health Profession in New York, who led the research (10).

 

Jefferey Koplan from Emory University in US and Judith Mackay from the World Lung Foundation in Hong Kong said, "in view of the health burden of tobacco use, the underinvestment in tobacco control is extraordinary. In low – income countries for every $9100 received in tobacco taxes, only $1 was spent on tobacco control" (10).They further added, "with behaviors and life style in flux globally and marketing rampant, we can except initiation of tobacco use to begin at younger ages than at present, and pressures on young women to smoke to increase".

 

CONCLUSION AND RECOMMENDATIONS:

As tobacco consuming is a modifiable habit hence the authors reached to the conclusion that there is an urgent need to make the people aware about various hazardous effect of tobacco. This is possible only by making the people aware through education, at multiple levels. In modern days, a number of ways has been developed to reach the people, how difficult to reach or far away the people are, we have to make them aware. It will be better to conduct an intensified awareness campaign, using all available media, both traditional (Folk dances and Folk songs etc.) and modern (Television, Mobile etc.). Thus Community may be motivated to quit the habit of smoking and thus saved billions of rupees of the nation in terms of man day's lost due to illness and expenses incurred on treatment. Otherwise millions of people are being forced to lead a miserable life each and every day (11 and 12).

 

ACKNOWLEDGEMENT:

The authors expresses their sincere thanks to Dr.A.K.Bansal, Ex-Professor and H.O.D., Department of Community Medicine, Govt.Medical College, Jagdalpur (Bastar) 494 001, India, for his constant guidance and encouragement in preparing the manuscript.

 

REFERENCES:

1.       Gupta R.and Singhal S.:Coronary heart disease in India; Circulation 1997 :96:3785

2.       Gupta, R. At odat NA, Gupta VP; Hypertension Epidemiology in India Meta analysis of 50 year prevalence rates and BP trends Hum Hyper tens 1996:10:465-472

3.       Gupta R.; Urban –rural differences in Coronary risk factor in Rajasthan 2000; Cardiology Today; Vol.V, No.4:230

4.       Howard G.Wagenknecht LE, Burka GL et L: Citrate smoking and progression of atherosclerosis. The atherosclerosis risk in community study: JAMA 1998 :279;119-124

5.       Willet W.C., Green A., Stampfer M.J.: Relative and absolute risk of study among women, who smoke cigarette, 1987; New Eng.J Med; 317; 1303-1309

6.       Garg Narendra K.: Evaluation of the impact of emesis and emesis plus purgation Therapy; Research J Pharmacology and Pharmacodynamics:2 (2) March-April;2010:201-202.

7.       Garg Narendra K and Sharma A.B.: Epidemiological profile of patients attending a tertiary care hospital, Muktsar, Punjab (India); Research J Pharmacology and Pharmacodynamics:3 (6) November-December;2011:311-317

8.       Meat is macho ? Vegetarians are viewed as less manly, says study: The Times of India, New Delhi, May 18, 2012 :pp-19

9.       S.R.Mittal and Monika Maheswari: Cardiovascular risk assessment classic risk factors present status medicine up date, Chaireman Scientific Committee 2004: Volume 14;Apicon 2004, 22-25.

10.     Female smokers out puff males : The Times of India, New Delhi, August 18, 2012 :pp-10

11.     Bansal A.K.and Garg Narendra K.: Information, Education, Communication in context of reproductive and child health including HIV/AIDS; J.Ravi Shankar Uni.; Vol.14; No.B(Science)2001; pp28-34.

12.     Garg Narendra K.and Bansal A.K.: Management information system in context of health care delivery: J.of Ravi Shankar Univ.; Vol.14; No.B(Science); 2001; pp35-40

 

 

 

 

 

Received on 06.01.2018       Modified on 19.02.2018

Accepted on 26.03.2018       ©A&V Publications All right reserved