Burden of waterpipe smoking and chewing tobacco use among women of reproductive age group using data from the 2012-13 Pakistan Demographic and Health Survey

Background: Despite the general decline in cigarette smoking, use of alternative forms of tobacco has increased particularly in developing countries. Waterpipe (WP) and Chewing Tobacco (CT) are two such alternative forms, finding their way into many populations. However, the burden of these alternative forms of tobacco and their socio demographic determinants are still unclear. We assessed the prevalence of WP and CT use among women of reproductive age group in Pakistan. Methods: Data from the most recent Pakistan Demographic and Health Survey 2012–13 (n = 13,558) was used for this analysis. Information obtained from ever married women, aged between 15 and 49 years were analyzed using two separate data subgroups; exclusive WP smokers (total n = 12,995) and exclusive CT users (total n = 12,771). Univariate and Multivariate logistic regression analyses were conducted and results were reported as crude and adjusted Odds Ratio with 95 % confidence intervals. Results: Prevalence of WP smoking and CT were 4 % and 2 %, respectively. After multivariate adjustments, ever married women who were: older than 35 years (OR; 4.68 95 % CI, 2.62–8.37), were poorest (OR = 4.03, 95 % CI 2.08–7.81), and had no education (OR = 9.19, 95 % CI 5.10–16.54), were more likely to be WP smokers. Similarly, ever married women who were: older than 35 years (OR = 3.19, 95 % CI 1.69–6.00), had no education (OR = 4.94, 95 % CI 2.62–9.33), were poor (OR = 1.64, 95 % CI 1.07–2.48) and had visited health facility in last 12 months (OR = 1.81, 95 % CI 1.22–2.70) were more likely to be CT users as well. Conclusion: Older women with lower socio-economic profile were more likely to use WP and CT. Focused policies aiming towards reducing the burden of alternate forms of tobacco use among women is urgently needed to control the tobacco epidemic in the country

Perceptions of psychosocial hazards, work-related stress and workplace priority risks in developing countries

Objectives: During the last few decades, major global developments in the world of work include an international trend to shift production to developing countries, with wide variations in working conditions and exposure to traditional and emerging occupational risks, such as psychosocial risks. The latter have rarely been addressed or explored in developing and economically-emerging country contexts while we find an abundant body of research from industrialized countries. The research presented, which is part of a larger study, explored the perception of multi-disciplinary experts from different regions, as defined by the World Health Organization (WHO), of the nature of psychosocial hazards, and work-related stress, as well as their views on workplace priorities that require urgent attention. Methods: Semi-structured interviews were conducted with 29 experts from developing countries which were subjected to thematic analysis. A two-tiered Delphi survey was completed by 74 experts in the first round with 53 of these experts completing the survey in the second round. Results: Psychosocial hazards and work-related stress were mostly seen as interchangeable in terms of source and effect and all participants perceived them as concern to their workforce. Through the interviews and the Delphi surveys they allude to our contemporary understanding of psychosocial risks. Workplace risks of priority differed by region but primarily work-related stress, injury and accident prevention, and substance abuse and risk behaviors were reported to require urgent attention. Conclusions: The current lack of awareness and research in the area of psychosocial risks and work-related stress hampers action in developing countries. International experts should support the exchange of information and the development of interventions in workplaces in developing countries with a view to integrating these emerging risks into comprehensive occupational health and safety policy frameworks to make such approaches more effective