An annotated bibliography of scientific studies done on tobacco topic in WHO South-East Asia Region countries 2003–2014, 9.18Mb

An annotated bibliography of scientiic
studies done on tobacco topic in
WHO South-East Asia Region countries
2003–2014

(Surveillance, health effects, economics, and control efforts)

WHO Library Cataloguing-in-publication data
World Health Organization, Regional office for South-East Asia.
An annotated bibliography of scientific studies done on tobacco topic in SEAR countries
2003 – 2014 (Surveillance, health effects, economics, and control efforts).
1. Bibliography.
5. South-East Asia.

2. Smoking Cessation.

3. Tobacco Industry.

4. Tobacco Use

I. Title

ISBN 978-92-9022-494-5

(NLM classification: WM 274)

Appreciate contribution from Ms Anuja Upadhyay and Dr Nihal Singh.

© World Health Organization 2015
All rights reserved.
Requests for publications, or for permission to reproduce or translate WHO publications –
whether for sale or for noncommercial distribution – can be obtained from SEARO Library,
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Gandhi Marg, New Delhi 110 002, India (fax: +91 11 23370197; e-mail: searolibrary@who.int).
The designations employed and the presentation of the material in this publication do not imply
the expression of any opinion whatsoever on the part of the World Health Organization
concerning the legal status of any country, territory, city or area or of its authorities, or
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they are endorsed or recommended by the World Health Organization in preference to others

of a similar nature that are not mentioned. Errors and omissions excepted, the names of
proprietary products are distinguished by initial capital letters.
All reasonable precautions have been taken by the World Health Organization to verify the
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This publication does not necessarily represent the decisions or policies of the World Health
Organization.
Printed in India

Table of Contents
Preface .................................................................................................................................... xi
Message .................................................................................................................................xiii
Introduction ...............................................................................................................................1
1.

Tobacco use surveillance (surveys and reports) ..............................................................1
1.1. Youth in general .......................................................................................................1
1.1.1. Global Youth Tobacco Survey (GYTS).........................................................2

1.1.2. Global Adult Tobacco Surveys (GATS) ........................................................2
1.2. Children (including school-going children) ...............................................................2
1.3. Health professionals (including medical and dental students) .................................2
1.3.1. Global Health Professions Student Survey (GHPSS)..................................2
1.4. Educational personnel and other professional groups.............................................2
1.4.1

2.

Global School Personnel Survey (GSPS)....................................................2

Tobacco-related morbidity and mortality ..........................................................................3
2.1. Cancers and other diseases related to tobacco use................................................3

3.

Tobacco control interventions (including policies, legislations and taxation)....................3

4.

Tobacco promotion-advertising and sponsorship .............................................................3

5.

Tobacco economics including interference of the tobacco industry .................................3

Country studies .....................................................................................................................5
BANGLADESH
1.

.....................................................................................................................7

Tobacco use surveillance (surveys and reports) ..............................................................7
1.1. Youth in General ......................................................................................................7
1.1.1. Global Youth Tobacco Surveys (GYTS) .......................................................8
1.1.2. Global Adult Tobacco Survey (GATS) ..........................................................9
1.2. Children (including school going children) .............................................................10
1.3. Health Professionals (including medical and dental students) ..............................12
1.3.1. Global Health Professions Student Survey (GHPSS)................................14
1.4. Educational Personnel and other professional groups ..........................................14

1.5. Rural communities .................................................................................................15
1.6. Urban communities ................................................................................................17

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1.7. Women...................................................................................................................19
1.8. General population ................................................................................................21
2.

Tobacco related Mortality & Morbidity ............................................................................27
2.1. Cancers related to tobacco use .............................................................................29
2.1.1. Head and neck cancers .............................................................................29
2.1.2. Thoracic cancers .......................................................................................30
2.1.3. Abdominal cancers ....................................................................................32
2.1.4. Other cancers ............................................................................................32
2.2. Non-cancerous diseases .......................................................................................33
2.2.1. Tuberculosis...............................................................................................33
2.2.2. Cardiovascular diseases............................................................................33

2.2.3. Diabetes.....................................................................................................38
2.2.4. Respiratory ................................................................................................41
2.2.5. Other diseases...........................................................................................43

3.

Tobacco control interventions (including policies, legislations and taxation)..................44

4.

Tobacco Promotion-Advertising and sponsorship ..........................................................48

5.

Tobacco economics including interference of the tobacco industry ...............................50

BHUTAN ...............................................................................................................................53
1.

Tobacco use surveillance (surveys and report) ..............................................................53

1.1. Youth in general .....................................................................................................53
1.1.1. Global Youth Tobacco Surveys (GYTS) .....................................................53
1.2. Educational Personnel and other professional Groups .........................................55
1.2.1. Global School Personnel Survey (GSPS)..................................................55
1.3. Women...................................................................................................................55

2.

Tobacco related Mortality & Morbidity ............................................................................55

3.

Tobacco control interventions (including policies, legislations and taxation)..................55

4.

Tobacco economics including tobacco interference of the tobacco industry..................58

DEMOCRATIC PEOPLE’S REPUBLIC OF KOREA .............................................................61
1.

Surveillance (Tobacco use surveys and reports) ...........................................................61

2.

Tobacco related Mortality & Morbidity ............................................................................61

3.

Tobacco control interventions (including policies, legislations and taxation)..................62

4.

Tobacco promotion: Advertising and sponsorship ..........................................................66

iv

An annotated bibliography of scientiic studies done on tobacco topic in WHO South-East Asia Region countries

INDIA ......................................................................................................................................69

1.

Tobacco use surveillance (surveys and reports) ............................................................69
1.1. Youth in general .....................................................................................................69
1.1.1. Global Youth Tobacco Survey (GYTS).......................................................76
1.1.2. Global Adult Tobacco Survey (GATS) ........................................................80
1.2. Children (including school going children) .............................................................88
1.3. Health professionals (including medical and dental students) .............................101
1.3.1. Global Health Professions Student Survey (GHPSS)..............................108
1.4. Educational Personnel and other professional groups ........................................109
1.4.1. Global School Personnel Survey (GSPS)................................................ 114
1.5. Rural communities ............................................................................................... 116
1.6. Urban communities ..............................................................................................127
1.7. Women.................................................................................................................134
1.8. Elderly .................................................................................................................140
1.9. General population ..............................................................................................143

2.

Tobacco related Morbidity and Mortality.......................................................................158

2.1. All Cancers related to tobacco use ......................................................................168
2.1.1. Head and Neck cancers ..........................................................................171
2.1.2. Thoracic cancers .....................................................................................184
2.1.3. Abdominal cancers ..................................................................................195
2.1.4. Other cancers ..........................................................................................197
2.2. Non- cancerous diseases ....................................................................................198
2.2.1. Tuberculosis.............................................................................................199
2.2.2. Cardiovascular diseases..........................................................................202
2.2.3. Diabetes................................................................................................... 211
2.2.4. Respiratory diseases ...............................................................................219
2.2.5. Other diseases.........................................................................................223

3.

Tobacco Control Interventions including Policies, Measures and Taxation ..................231

4.

Tobacco Promotion: Advertising and Sponsorship .......................................................273

5.

Tobacco economics including interference of the tobacco industry .............................282

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INDONESIA..........................................................................................................................293
1.

Tobacco use Surveillance (surveys and reports) .........................................................293
1.1. Youth in general ...................................................................................................293
1.1.1. Global Youth Tobacco Survey (GYTS).....................................................293
1.1.2. Global Adult Tobacco Surveys (GATS) ....................................................295
1.2. Children (including school going children) ...........................................................295
1.3. Health professionals (including medical and dental students) .............................296
1.3.1. Global Health Personnel Student Survey (GHPSS) ................................298
1.4. Educational Personnel and other professionals ..................................................298
1.4.1. Global School Personnel Survey (GSPS)................................................299
1.5. Rural communities ...............................................................................................299
1.6. Urban communities ..............................................................................................299
1.7. Women.................................................................................................................300
1.8. General population ..............................................................................................302

2.

Tobacco related Mortality & Morbidity ..........................................................................304
2.1. Cancers related to tobacco use ...........................................................................305
2.1.1. Head and Neck Cancers..........................................................................306
2.1.2. Thoracic cancers .....................................................................................308
2.1.3. Abdominal cancers ..................................................................................308
2.1.4. Other cancers ..........................................................................................308
2.2. Non- cancerous diseases ....................................................................................309
2.2.1. Tuberculosis.............................................................................................309
2.2.2. Cardiovascular diseases..........................................................................309
2.2.3. Diabetes...................................................................................................310
2.2.4. Respiratory ..............................................................................................312
2.2.5. Other diseases.........................................................................................312

3.

Tobacco control interventions (including policies, legislations and taxation)................313

4.

Tobacco Promotion-Advertising and sponsorship ........................................................319

5.

Economics of tobacco including interference of tobacco industry................................321

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An annotated bibliography of scientiic studies done on tobacco topic in WHO South-East Asia Region countries

MALDIVES ...........................................................................................................................329
1.

Tobacco use Surveillance (surveys and reports) .........................................................329
1.1. Youth in general ...................................................................................................329
1.1.1. Global Youth Tobacco Survey(GYTS)......................................................329
1.2. Educational Personnel and other professionals ..................................................330
1.2.1

Global School Personnel Survey(GSPS).................................................330

1.3. General population ..............................................................................................331
2.

Mortality & Morbidity.....................................................................................................332

3.

Tobacco control interventions (including policies, legislations and taxation)................333

4.

Tobacco economics including Interference of tobacco industry ...................................338

MYANMAR ...........................................................................................................................341
1.

Tobacco use Surveillance (surveys and reports) .........................................................341
1.1. Youth in general ...................................................................................................341
1.1.1. Global Youth Tobacco Survey ..................................................................341
1.1.2. Global Adult Tobacco Surveys .................................................................342
1.2. Health professionals (including medical and dental students) .............................342
1.2.1. Global Health Professions Students Survey (GHPSS) ............................343
1.3. Educational professionals and other professionals .............................................344
1.3.1. Global School Personnel Survey (GSPS)................................................344
1.4. Women.................................................................................................................344
1.5. General population ..............................................................................................344

2.

Tobacco related Mortality & Morbidity ..........................................................................346
2.1. Cancers related to tobacco use ...........................................................................346
2.1.1. Head and Neck cancers ..........................................................................346
2.1.2. Thoracic cancers .....................................................................................347
2.1.3. Cardiovascular diseases..........................................................................347
2.1.4. Diabetes...................................................................................................348

3.

Tobacco control interventions (including policies, legislations and taxation)................348

4.

Tobacco promotion: Advertising and sponsorship ........................................................353

5.

Tobacco economics including interference of tobacco industry ...................................353

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NEPAL..................................................................................................................................357
1.

Tobacco use Surveillance(surveys and reports) ..........................................................357
1.1. Youth in general ...................................................................................................357
1.1.1. Global Youth Tobbacco Survey(GYTS)....................................................358
1.2. Children (including school going children) ...........................................................361
1.3. Health professionals( including medical and dental students) .............................364
1.3.1. Global Health Professional Students Survey(GHPSS) ............................367
1.4. Educational personnel and other professional groups........................................369
1.4.1. Global School Personnel Survey (GSPS)..............................................370
1.5. Rural communities ...............................................................................................370
1.6. Urban communities ..............................................................................................371
1.7. Women.................................................................................................................371
1.8. General population ..............................................................................................375

2.

Tobacco related Morbidity and Mortality.......................................................................378
2.1. Cancers related to tobacco use ...........................................................................379
2.1.1. Head and neck cancers ...........................................................................379
2.1.2. Thoracic cancers .....................................................................................379
2.1.3. Other cancers ..........................................................................................381
2.2. Non- cancerous diseases ....................................................................................381
2.2.1. Tuberculosis.............................................................................................381
2.2.2. Cardiovascular diseases..........................................................................384
2.2.3. Diabetes...................................................................................................389
2.2.4. Respiratory ..............................................................................................390
2.2.5. Other diseases.........................................................................................393

3.

Tobacco control interventions (including policies, legislations and taxation)................397

4.

Tobacco promotion: Advertising and sponsorship ........................................................404

5.

Tobacco economics including tobacco industry interference .......................................404

SRI LANKA ..........................................................................................................................407
1.

Tobacco use Surveillance (surveys and reports) .........................................................407
1.1. Youth in general ...................................................................................................407
1.1.1. Global Youth Tobacco Survey (GYTS).....................................................407
1.2. Children (including school going children) ...........................................................409

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An annotated bibliography of scientiic studies done on tobacco topic in WHO South-East Asia Region countries

1.3. Health professionals (including medical and dental students) .............................410
1.3.1. Global Health Personnel Student Survey (GHPSS) ................................410
1.4. Educational Personnel and other professional groups ........................................ 411
1.4.1. Global School Personnel Survey (GSPS)................................................ 411
1.5. Rural communities ............................................................................................... 411
1.6. Urban communities ..............................................................................................414
1.7. Women.................................................................................................................414
1.8. General population ..............................................................................................414
2.

Tobacco related Mortality & Morbidity ..........................................................................416
2.1. Cancers related to tobacco use ...........................................................................417
2.1.1. Head and Neck cancers ..........................................................................417
2.1.2. Other cancers ..........................................................................................421
2.2. Non- cancerous diseases ....................................................................................422
2.2.1. Cardiovascular diseases..........................................................................422
2.2.2. Diabetes...................................................................................................422
2.2.3. Other diseases.........................................................................................423

3.

Tobacco control interventions (including policies, legislations and taxation)................424

4.

Tobacco promotion: Advertising and sponsorship ........................................................429

5.

Tobacco economics including Interference of tobacco industry ...................................429

THAILAND ...........................................................................................................................433
1.

Tobacco use Surveillance (surveys and reports) .........................................................433
1.1. Youth in general ...................................................................................................433
1.1.1. Global Youth Tobacco Survey (GYTS).....................................................436
1.1.2. Global Adult Tobacco Survey (GATS) ......................................................437
1.2. Children (including school going children) ...........................................................439
1.3. Health professionals (including medical and dental students) .............................441
1.3.1. Global Health Professions Student Survey (GHPSS)..............................445
1.4. Educational personnel and other professional groups.........................................445
1.4.1. Global School Personnel Survey (GSPS)................................................445
1.5. Rural communities ...............................................................................................445
1.6. Women.................................................................................................................447
1.7. Elderly 448
1.8. General population ..............................................................................................449

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2.

Tobacco related Mortality & Morbidity ..........................................................................454
2.1. Cancers related to tobacco use ...........................................................................455
2.1.1. Head and Neck cancers ..........................................................................455
2.1.2. Thoracic cancers .....................................................................................458
2.1.3. Abdominal cancers ..................................................................................460
2.1.4. Other cancers ..........................................................................................461
2.2. Non- cancerous diseases ....................................................................................461
2.2.1. Tuberculosis.............................................................................................461
2.2.2. Cardiovascular diseases..........................................................................462
2.2.3. Diabetes...................................................................................................463
2.2.4. Respiratory ..............................................................................................465
2.2.5. Other diseases.........................................................................................465

3.

Tobacco control interventions (including policies, legislations and taxation)................468

4.

Tobacco Promotion: Advertising and sponsorship .......................................................480

5.

Economics of tobacco including interference of the tobacco industry..........................482

TIMOR-LESTE .....................................................................................................................491
1.

Tobacco use Surveillance (surveys and reports) .........................................................491
1.1. Youth in general ...................................................................................................491
1.1.1. Global Youth Tobacco Survey (GYTS).....................................................491
1.2. Children (including school going children) ...........................................................493
1.3. Educational professionals and other professional groups ...................................493
1.3.1. Global School Personnel Survey (GSPS)................................................493
1.4. Women.................................................................................................................493
1.5. General population ..............................................................................................494

2.

Tobacco control interventions (including policies, legislations and taxation)................496

3.

Tobacco economics including Interference of tobacco industry ...................................500

ANNEX List of authors .......................................................................................................505

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An annotated bibliography of scientiic studies done on tobacco topic in WHO South-East Asia Region countries

Preface

Data based evidence on magnitude and pattern of Morbidity and Mortality attributable to
Tobacco use is often scarce and scattered. It is more so when tobacco is used in various
forms as smokeless (perhaps even more harmful to health than smoking). Although WHO
guided surveys to determine the prevalence of all known types of tobacco use have been
and continue to be carried out in almost all countries of WHO south-East Asia Region, none
we know of has been done in a systematic manner on such a larger scale in SEA Region on
disease burden due to tobacco use.
The tobacco, what began as a pride of man using for self in varied forms and prestige
in offering to others as a social etiquette for generations up until recently, has been found by
scientific studies injurious to health. This scientific evidence that tobacco use in any form has
adverse effect on health was the basis on which WHO's Framework Convention on Tobacco
Control (FCTC) and Tobacco Free Initiative came into existence to monitor and control
tobacco use besides continuing search for further evidence to establish without any doubt
that tobacco is a major risk factor for triggering certain diseases leading to disabilities and
deaths.
This being so, the focused studies (though small and sparse) done and published by
academicians, clinicians, epidemiologists and health scientists over the years in SEAR
countries are even of more relevance to look at until a comprehensive survey is done for this
purpose.
While abstracts of all about 1000 studies done on any aspect of tobacco use in SEAR
countries and published in various Journals are presented in Part-I of this publication, only
those on tobacco related morbidity and mortality are tabulated and analyzed in Part-II.
Since most of these studies were on prevalence and pattern of tobacco use and other
elements of WHO's MPOWER strategy for tobacco control, only abstracts related to tobacco
attributed morbidity and mortality were selected for Part-II. All SEAR countries had studies
on various aspects of tobacco use., only six countries (Bangladesh, India, Indonesia, Nepal,
Sri Lanka, and Thailand) had on morbidity and mortality as well.
The reference years of most of these studies were 2003 - 2014, a few were done in
1990s and 1980s. Some of the morbidity and mortality related studies were general with
casual mention of tobacco, we selected only those which examined harm and hazard of
tobacco on health and there too only those which attempted to relate and quantify the
tobacco risk by type of disease. Further filtering was done to select those studies which used
multivariate logistic analysis of nested (multidimensional contingency tables) for Odds ratio
in order to assess excess risk due to tobacco use over non-users independent of other covariates.
The statistical data in terms of relative risk (RR), odds ratio (OR), hazard ratio (HR),
and percentage of tobacco attributed cases and deaths were extracted from selected studies
and were tabulated by PMID number of the study. Also extracted and tabulated along were
details of sample size, subject type, and study setting. The full text of the articles can be
accessed online by entering PMID number at http://www.ncbi.nlm.nih.gov/pubmed.

An annotated bibliography of scientific studies done on tobacco topic in WHO South-East Asia Region countries

xi

Message

WHO has been guiding studies and surveys to determine the
prevalence, social and economic determinants and the health impact of
all known types of tobacco use in countries of the WHO South-East
Asia Region.
Scientific evidence that tobacco use in any form has adverse
effects on health has been the basis on which WHO's Framework
Convention on Tobacco Control (FCTC) and Tobacco Free Initiative
came into existence. FCTC monitors and controls tobacco use in
addition to seeking more evidence for establishing that tobacco is a
major risk factor for chronic diseases and premature deaths.
The focused studies (although small and sparse) done and published by academicians,
clinicians, epidemiologists and health scientists over the years in the Region are a critical
component for future comprehensive research for advancing tobacco control.
This publication presents abstracts of about 1000 studies conducted in the Region on
various aspect of tobacco – socio-demographic dimensions of tobacco use, access and
availability of tobacco products, surveillance and monitoring, illicit trade of tobacco products,
impact of tobacco advertisements, techniques of tobacco industry interference, tobacco
control intervention and their impact, and taxation and other tobacco control measures
adopted by countries in the Region.
Notable among these are the studies on smoking attributable morbidity and mortality
from Bangladesh, India, Indonesia, Nepal, Sri Lanka and Thailand; and diseases and deaths
caused by use of smokeless tobacco use in Bangladesh and India.
We hope that this collection of studies will be useful in understanding the challenges in
tobacco control, lessons learnt from the interventions made between 2003 and 2014 and the
need for initiating research to guide and intensify tobacco control strategies.

Dr Poonam Khetrapal Singh
Regional Director

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xiii

Introduction
Part I o f t h i s report is a compilation of abstracts of published research studies done from 2003 to 2014
on tobacco in countries of the World Health Organization South-East Asia Region (WHO/SEARO). Although
most of the abstracts were originally prepared by the authors, we provide Pub Med ID of each study to access
its full text as well. The purpose of creating this comprehensive database is to form a pool of information
at one place for researchers to look at what has already been studied and what issues and research
studies to take up next, and for use by public health policy advocates who may be looking for information
on tobacco use pattern, impact or control in the South-East Asia Region. Studies are organized by subject
matter such as tobacco use surveillance (surveys and reports); tobacco-related mortality and morbidity
information including cancerous and non cancerous diseases; tobacco control interventions including policy
measures, legislations and taxation; reports on tobacco promotion, advertising and sponsorship; economics of
tobacco including studies on the interference of the tobacco industry. Pubmed, Medline, Taylor and Francis, Sage,
JSTOR, OUP, Springer, PROQUEST and Science Direct databases have been used. In addition to research
studies, some editorials, letters and news articles containing interesting ideas and useful information were
also included. Some articles are listed more than once, if they fall into more than one of the
categories/subcategories or regions.
Keywords: The keywords used for searches were: smoking or tobacco, gutkha, pan masala, betel quid, areca
nut, beedi workers AND name of each country or South-East Asia, cessation, advertisements, health impacts of
AND tobacco or smoking, tobacco control policies and measures, second-hand smoke, tobacco use surveys
and reports; tobacco industry interference, tobacco- related tax, name of tobacco-related diseases AND
cancer, workers AND tobacco industry AND the names of each country (Bangladesh, Bhutan, India, Indonesia,
Democratic People‘s Republic of Korea, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste) or SouthEast Asia.
The five broad categories of the report are:

1.

Tobacco use surveillance (surveys and reports)

This section includes abstracts of tobacco use surveys that have been conducted in different areas of the
WHO S o uth-East Asian countries to gather data on the use of tobacco by population, awareness of health
effects of tobacco and attitudes towards tobacco use and efforts to discourage its use. Other articles
summarized here are condensed reports/ or information on tobacco use patterns or events that changed
tobacco use in an area. This section is divided into subsections, by type of population reported on.
Information on or related to some of the important Global Tobacco Surveillance Surveys (GYTS, GATS,
GHPSS and GSPS) and International Tobacco Control (ITC) Policy Evaluation Project‘s cohort studies in
M ember States have also been included.
The International Tobacco Control Policy Evaluation Project (the ITC Project) is the first-ever international
cohort study of tobacco use being conducted in 20 countries. It is designed to evaluate the impact of
policies implemented under the World Health Organization (WHO) Framework Convention on Tobacco
Control (FCTC). Each ITC Survey follows standardized protocols and includes rigorous measures to assess
the impact and identify the determinants of effective tobacco control policies in the following areas:

•
•
•
•
•

Health warning labels and package descriptors
Smoke-free legislation
Pricing and taxation of tobacco products
Education and support for cessation
Tobacco advertising and promotions

The ITC Survey findings provide an evidence base to guide policies enacted under the FCTC, and to
systematically evaluate the effectiveness of these legislative efforts.

1.1. Youth in general
Abstracts of articles listed in this section cover tobacco use in youth in the South-East Asia Region,
pointing out similarities among youth of the different countries in the region and particularities of tobacco use
by youth in each different region and the reasons why youth in different countries use tobacco and in the forms
it takes. It also includes the GYTS and GATS surveys.

An annotated bibliography of scientific studies done on tobacco topic in WHO South-East Asia Region countries

1

Introduction

1.1.1. Global Youth Tobacco Survey (GYTS)
The Global Youth Tobacco Survey is a school-based survey designed to enhance the capacity of countries to
monitor tobacco use among youth and to guide the implementation and evaluation of tobacco prevention and
control programmes. The GYTS uses a standard methodology for constructing the sampling frame, selecting
schools and classes, preparing questionnaires, following consistent field procedures, using consistent data
management procedures for data processing and analysis. The information generated from the GYTS can be
used to stimulate the development of tobacco control programmes and can serve as a means to assess progress
in meeting programme goals. In addition, GYTS data can be used to monitor seven Articles in the WHO FCTC.
The GYTS data (2007 and 2009) from 10 Member States of the WHO South-East Asia Region are covered under
the GYTS sub category. Fact sheets and reports are available for member countries at:
http://www.searo.who.int/tobacco/data/en/

1.1.2. Global Adult Tobacco Surveys (GATS)
The Global Adult Tobacco Survey (GATS) is a nationally representative household survey that was launched in
February 2007 as a new component of the ongoing Global Tobacco Surveillance System (GTSS). GATS
enables countries to collect data on adult tobacco use and key tobacco control measures. Results from GATS
assist countries in the formulation, tracking and implementation of effective tobacco control interventions, and
countries are able to compare results of their survey with results from other countries.

GATS data from four Member S tates (Bangladesh, India, Indonesia and Thailand) of the WHO South- East
Asia Region are covered under GATS. Fact sheets and reports are available for Member States at:
http://www.searo.who.int/tobacco/data/en/

1.2. Children (including school-going children)
1.3. Health professionals (including medical and dental students)
1.3.1. Global Health Professions Student Survey (GHPSS)
The World Health Organization, CDC, and the Canadian Public Health Association developed the GHPSS to
collect data on tobacco use and cessation counseling among health professional students in all WHO Member
States.
GHPSS is a standardized school-based survey of third-year students pursuing advanced degrees in dentistry,
medicine, nursing, or pharmacy. It is conducted in schools during regular class sessions. GHPSS follows an
anonymous, self-administered format for data collection. GHPSS uses a core questionnaire on demographics,
prevalence of cigarette smoking and other tobacco use, knowledge and attitudes about tobacco use,
exposure to secondhand smoke, desire for smoking cessation, and training received regarding patient
counseling on smoking cessation techniques. Questionnaires are translated into local languages as needed.
GHPSS has a standardized methodology for selecting participating schools and classes and uniform dataprocessing procedures.
The WHO FCTC Indicators: GHPSS 2005-2009 (Medical) document contains Global Health Professions
Student Survey data (of medical students) from seven Member States of the WHO South-East Asia Region. It is
not only a convenient format to disseminate data widely but is also a source of valuable data for researchers,
programme managers, advocates and any interested organizations or individuals. It will provide them the
necessary data to carry out further analyses and bring about policy changes and appropriate public health
interventions.

1.4. Educational personnel and other professional groups
1.4.1 Global School Personnel Survey (GSPS)
The GSPS is a survey of teachers and administrators working in schools selected to participate in the GYTS. It
uses self-administered, anonymous data-collection procedures. Names of schools or personnel are not
collected, and participation is voluntary. Surveys are completed at schools, generally at staff meetings or after
school.

2

An annotated bibliography of scientific studies done on tobacco topic in WHO South-East Asia Region countries

Introduction

The WHO FCTC Indicators: GSPS document presents data from school personnel employed in schools. Ten
Member States of the WHO South-East Asia Region participated in the survey and provided data from 2006 to
2009. This has sub-sections such as: rural communities; urban communities; women; elderly; and general
population

2.

Tobacco-related morbidity and mortality

This section is a wide review of mortality and morbidity associated with tobacco use. Reports describe the
effects on overall mortality and/or morbidity of tobacco use in countries of the SEA Region and relative risks of
the various forms of tobacco use. Abstracts of studies on toxicity of tobacco products and those
investigating cancer are also included with a focus on both cancerous and non cancerous diseases due to
tobacco.

2.1. Cancers and other diseases related to tobacco use
This section includes abstracts on all-cause mortality, tobacco-related specific mortality and morbidity

3.

Tobacco control interventions (including policies, legislations and
taxation)

This section includes abstracts on interventions to modify tobacco use behaviour, even change in
behaviour, and overall impact on health after tobacco-related health education. Strategies proposed or used in
an intervention are also covered in this section. Besides this, abstracts on or related to existing policies,
legislations and litigations including taxation for tobacco control are also incorporated.

4.

Tobacco promotion-advertising and sponsorship

Promotion of tobacco products through advertisements and sponsorship of programs by tobacco companies are
covered in this section.

5.

Tobacco economics including interference of the tobacco industry

This section covers the economic gains and loss to the different countries in the Region including loss in
health expenditure due to tobacco production. Tobacco employment, tobacco growing and technology, health
hazards and costs faced by tobacco workers and alternate uses of tobacco are also included in this
section. Transnational companies‘ efforts to expand their operations in Asia as well as internal issues in
multinationals have also been incorporated.

An annotated bibliography of scientific studies done on tobacco topic in WHO South-East Asia Region countries

3

Country Studies

BANGLADESH
1.

Tobacco use surveillance (surveys and reports)

1.1. Youth in General
Abdullah AS, Driezen P, Ruthbah UH, Nargis N, Quah AC, Fong GT. Patterns and predictors of smokeless
tobacco use among adults in Bangladesh: findings from the International Tobacco Control (ITC)
Bangladesh survey. PLoS One. 2014 Jul 9; 9(7):e101934. doi: 10.1371/journal.pone.0101934. eCollection
2014.
Abstract
BACKGROUND: Although smokeless tobacco (SLT) use is prevalent in South Asian countries including
Bangladesh, information about the pattern and correlates of SLT use is scarce. This study described the pattern
and predictors of SLT use among Bangladeshi adults.
METHODS: The data for this study were derived from the International Tobacco Control Policy Evaluation
Bangladesh (ITC BD) Survey, a prospective cohort survey of a nationally representative sample of smokers and
non-smokers, conducted during November 2011 and May 2012. The study included 5522 adults aged 15 or
above. We used multiple logistic regression models to identify predictors of SLT use.
RESULTS: Of the respondents (N = 5522), 20% were SLT users. In general, SLT use was significantly higher
among women, the illiterate and residents of the Dhaka slums or non-tribal/non-border areas outside Dhaka; SLT
use increased with age. Several attitudinal factors were also associated with SLT use. Multivariable logistic
regression analyses revealed several predictors of SLT use: being female (OR = 1.96, 95% confidence interval,
CI: 1.18-3.24), an increasing age, being a resident of a Dhaka slum (OR = 5.86; 95% CI: 3.73-9.21) or nontribal/non-border areas outside Dhaka (OR = 3.42; 95% CI: 1.94-6.03), being illiterate (OR = 3.37; 95% CI: 1.995.71), holding positive opinion towards societal approval of SLT use (OR = 5.84; 95% CI: 3.38-10.09), holding
positive opinion towards SLT use by women (OR = 2.63; 95% CI: 1.53-4.54), believing that SLT is addictive
(OR = 2.96; 95% CI: 1.51-5.81), and believing SLT is less harmful than bidi (OR = 2.22; 95% CI: 1.36-3.62).
CONCLUSION: The findings suggest that coordinated efforts of governmental and non-governmental
organizations, targeting both smoked tobacco and SLT use reduction and cessation, could be modified to reach
each level of population including those who are marginalized, female, less educated and elderly. As most
tobacco control programs in Bangladesh target mainly cigarette or bidi smoking, coordinated programs are
needed that will also include SLT use within the tobacco control policy and prevention strategies.
PMID: 25007266 [PubMed - in process] PMCID: PMC4090160
_____________

The International Tobacco Control Policy Evaluation Project: ITC Bangladesh Report on Smoke Free Policies.
Findings from the Wave 1 (2009) and Wave 2 (2010) Surveys. University of Waterloo, Waterloo, Ontario,
Canada; University of Dhaka, Dhaka, Bangladesh. May 2011
The International Tobacco Control Policy Evaluation Project: ITC Bangladesh Report on Tobacco Warning
Labels. Findings from the Wave 1 (2009) and Wave 2 (2010) Surveys. May 2011.
Summary
ITC Bangladesh Survey Wave 2 Survey (March to June 2010) consisted of 2,311 adult smokers including 2,191
Wave 1 recon tact smokers (93% retention from Wave 1) and 120 replenishment smokers)