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      Prevalence of Physical Nicotine Dependence and its Determinants among Tobacco users in the Rural Field Practice Area of a Tertiary Care Hospital in Tamil Nadu, India

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          Abstract

          Background:

          Tobacco is the major cause of preventable death globally, which kills one person prematurely every six seconds. In India, around 46.9% of men and women aged 15 years and above use any kind of tobacco, according to NFHS-5. Tobacco use for longer duration with increased frequency is often addictive. Nicotine in tobacco is often associated with dependence, which is recognized as a public health menace and the single most significant factor for premature death. Hence, assessment of nicotine dependence among tobacco users is essential to implement tobacco control measures effectively. To estimate the prevalence of nicotine dependence among tobacco users and to study the factors associated with nicotine dependence among those tobacco users in a rural area of Kancheepuram district, Tamil Nadu.

          Material and Methods:

          A community-based descriptive cross-sectional study was conducted among 375 tobacco users aged 18 years and above residing permanently in the rural field practice area of the Rural Health and Training Centre (RHTC) attached to a Tertiary Care Hospital in Tamil Nadu. The study has been conducted for 6 months. A systematic random sampling technique was used to recruit the study participants. Data was collected by conducting personal interviews using a pre-tested semi-structured questionnaire. The data obtained was subjected to statistical analysis using SPSS version 23.

          Result:

          About 48.7% of the study participants had high dependence, 25% had moderate dependence, and 26.3% had low physical dependence on nicotine. The duration of tobacco use ( P < 0.0000) and age of initiation of tobacco use (mean age was 28 ± 7.1 years) ( P < 0.0001) was found as a significant risk indicator for nicotine dependence.

          Conclusion:

          The high nicotine dependence (48.7%) among the study participants is quite alarming and warrants more visible and aggressive anti-tobacco campaigns and targeted preventive strategies.

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          Most cited references18

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          The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire

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            Smoking and nicotine dependence in Singapore: findings from a cross-sectional epidemiological study.

            Smoking is one of the leading preventable causes of death throughout the world and can lead to nicotine dependence, particularly when initiated at a young age. This paper describes the prevalence of smoking and nicotine dependence in the adult Singapore resident population, whilst also exploring rates among the major ethnic groups (Chinese, Malay and Indian), different education levels and those with chronic psychiatric and physical comorbidities. The Singapore Mental Health Study (SMHS) is a cross-sectional epidemiological study that was conducted between December 2009 and December 2010. Information on smoking status was assessed using the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and the Fagerstrom Test for Nicotine Dependence measured nicotine dependence. Socio-demographic information was also collected. In total, 6616 respondents participated in the SMHS giving a response rate of 75.9%. We found that 16% of the population were current smokers and 4.5% had nicotine dependence. Current smokers were more likely to be younger (18 to 34 years old), males, Malay and have lower education, whilst males had a 4.6 times higher risk of nicotine dependence to that of females. The prevalence of nicotine dependence was also higher in those with alcohol abuse and those experiencing chronic pain. The results from this study highlight the important differences in the prevalence of smoking and nicotine dependence among different age groups, gender and ethnicity in Singapore and are important for developing future health policies and targeted preventive strategies.
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              Prevalence of Depression, Suicidal Ideation, Alcohol Intake and Nicotine Consumption in Rural Central India. The Central India Eye and Medical Study

              Background To investigate the prevalence of depression, suicidal ideations, alcohol and nicotine consumption in adults in an agrarian society mostly unchanged by the effects of urbanization. Methods The Central India Eye and Medical Study is a population-based study in rural Central India close to the tribal belt and included 4711 subjects (aged 30+ years). Depression was assessed by the Center for Epidemiologic Studies Depression Scale (CESD), suicidal ideation by six standardized questions, nicotine use by the Fagerstroem Nicotine Tolerance Questionnaire (FTNQ), and alcohol consumption by the Alcohol Use Disorders Identification Test (AUDIT). Results Mild to moderate depression (CESD sum score: 15–21) was detected in 1862 (39.6%) individuals (33.5% of men, 44.8 of women), and major depression (CESD sum score >21) in 613 (13.0%) individuals (8.1 of men, 17.3% of women). Suicide attempt was reported by 199 (4.2%) participants and suicidal thoughts during the last 6 months by 238 (5.1%) individuals. There were 887 (18.9%) smokers and smokeless tobacco was consumed by 1968 (41.8%) subjects. Alcohol consumption was reported by 1081 (23.0%) participants; 283 (6.0%) subjects had an AUDIT score ≥8 (hazardous drinking), and 108 (4.63%) subjects a score ≥13 (women) or ≥15 (men) (alcohol dependence). Conclusions In rural Central India, prevalence of major depression was comparable to figures reported from other developing countries. Prevalence of smoking and hazardous alcohol consumption was higher than as reported from urban regions. Measures should be taken to address the relatively high prevalence of suicide attempts and thoughts on suicide in rural Central India.
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                Author and article information

                Journal
                Indian J Community Med
                Indian J Community Med
                IJCM
                Indian J Community Med
                Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine
                Wolters Kluwer - Medknow (India )
                0970-0218
                1998-3581
                Jan-Feb 2024
                12 January 2024
                : 49
                : 1
                : 170-174
                Affiliations
                [1]Department of Community Medicine, Sri Lalithambigai Medical College and Hospital, Faculty of Medicine, Dr. M. G. R. Educational and Research Institute, Chennai, Tamil Nadu, India
                [1 ]Department of Community Medicine, Sri Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
                Author notes
                Address for correspondence: Dr. Anugraha J, Assistant Professor, Department of Community Medicine, Sri Lalithambigai Medical College and Hospital, Faculty of Medicine, Dr. M. G. R. Educational and Research Institute, Tamil Nadu, India. E-mail: anugrahajohn1995@ 123456gmail.com
                Article
                IJCM-49-170
                10.4103/ijcm.ijcm_346_23
                10900451
                38425948
                4f480838-5c06-48ab-8761-d0158cafe66e
                Copyright: © 2024 Indian Journal of Community Medicine

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 30 May 2023
                : 09 November 2023
                Categories
                Original Article

                Public health
                nicotine dependence,smoking,tobacco users
                Public health
                nicotine dependence, smoking, tobacco users

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