Afghan frontier: understanding tobacco practices among migrant population in India

Background According to the World Refugee Survey by US Committee for Refugees and Immigrants, migrants from Afghanistan constitute the 4 th largest group of migrants to India. No previous studies have been conducted to assess the tobacco consumption status and pattern among this migrant population. Hence the aim of our study was to understand the tobacco use patterns and barriers among the migrant population from Afghanistan. Methods A cross-sectional study was conducted among a convenience sample of 127 Afghan tobacco users residing in Delhi, India in the month of June, 2017. A close-ended self-administered validated questionnaire translated in Persian language was circulated among Afghan tobacco users visiting local cafés and restaurants. The questionnaire assessed their socio-demographic factors, tobacco use patterns and barriers to tobacco cessation. Data was entered into digital spreadsheets and descriptive inferences were drawn. (SPSS v.21) Results A total of 127 male Afghan tobacco users with mean age of 33.49 ± 11.97 years voluntarily completed the questionnaire. Better work opportunities were the most common reason for migration. Most of them (69%) smoked tobacco and 15.5% only used Naswar. Half (52%) of the respondents continue to use tobacco products manufactured in Afghanistan with 62% procuring the product through social means (friends/family). Higher cost of tobacco products and stringent law enforcements in India were common barriers to tobacco use. Personal barriers to quitting included loss of social circle and fear of withdrawal symptoms among the respondents. Strikingly, 93% were unaware about the availability of local cessation services. Conclusions Majority of the Afghan respondents continue to use products manufactured in Afghanistan, probably as an attempt to hold fast to their culture and social practices. Since most of the respondents are unaware about the availability of cessation services, attempts should be made to generate awareness and motivate them to quit