ArticleBMC public health2021
Changes in adult smoking behaviours in ten global adult tobacco survey (GATS) countries during 2008-2018 - a test of 'hardening' hypothesis'.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed.
- Inequalities in lifestyle and metabolic risk factors across wealth and education levels among TUMS employees.BMC public health · 2026Article
- Low-intensity daily smoking and mortality risk among Mexican women.Tobacco control · 2024Article
- Two-Hour Nicotine Withdrawal Improves Inhibitory Control Dysfunction in Male Smokers: Evidence from a Smoking-Cued Go/No-Go Task ERP Study.Neuropsychiatric disease and treatment · 2024Article
- Smokeless and combustible tobacco use among 148,944 South Asian adults: a cross-sectional study of South Asia Biobank.BMC public health · 2023Article
- Hardening determinants among adult daily smokers in nine African countries: Data from the Global Adult Tobacco Survey.Preventive medicine reports · 2023Article
- Social participation and risk of developing dementia.Nature aging · 2023Review
- Association of tobacco use with the tobacco-related built environment: an ecological study from urban slums of Bhopal, India.Global health research and policy · 2023Article
- Comparison between Smokers and Smokeless Tobacco Users in Their Past Attempts and Intentions to Quit: Analysis of Two Rounds of a National Survey.International journal of environmental research and public health · 2022Article
- Pathophysiology, phenotypes and management of type 2 diabetes mellitus in Indian and Chinese populations.Nature reviews. Endocrinology · 2022Review
- The burden of nicotine-dependent smokers in China: The role of primary healthcare providers.The Lancet regional health. Western Pacific · 2022Article
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Abstract
backgroundHardcore smoking behaviours and test of hardening are seldom reported from low-and-middle-income countries (LMICs). We report country-wise changes in smoking behaviors between two sequential surveys and explored ecologically the relationship between MPOWER scores and smoking behaviors including hardcore smoking.
methodsWe analysed sequential Global Adult Tobacco Survey (GATS) data done at least at five years interval in 10 countries namely India, Bangladesh, China, Mexico, Philippines, Russia, Turkey, Ukraine, Uruguay, and Vietnam. We estimated weighted prevalence rates of smoking behaviors namely current smoking (both daily and non-daily), prevalence of hardcore smoking (HCS) among current smokers (HCSs%) and entire surveyed population (HCSp%), quit ratios (QR), and the number of cigarettes smoked per day (CPD). We calculated absolute and relative (%) change in rates between two surveys in each country. Using aggregate data, we correlated relative change in current smoking prevalence with relative change in HCSs% and HCSp% as well as explored the relationship of MPOWER score with relative change in smoking behaviors using Spearman' rank correlation test.
resultsOverall daily smoking has declined in all ten countries lead by a 23% decline in Russia. In India, Bangladesh, and Philippines HCSs% decreased as the smoking rate decreased while HCSs% increased in Turkey (66%), Vietnam (33%) and Ukraine (15%). In most countries, CPD ranged from 15 to 20 sticks except in Mexico (7.8), and India (10.4) where CPD declined by 18 and 22% respectively. MPOWER scores were moderately correlated with HCSs% in both sexes (r = 0.644, p = 0.044) and HCSp% (r = 0.632, p = 0.05) and among women only HCSs% (r = 0.804, p = 0.005) was significantly correlated with MPOWER score.
conclusionWith declining smoking prevalence, HCS had also decreased and quit rates improved. Ecologically, a positive linear relationship between changes in smoking and HCS is a possible evidence against 'hardening'. Continued monitoring of the changes in quitting and hardcore smoking behaviours is required to plan cessation services.
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