Concurrent Tobacco Use in UK Resident Bangladeshi Men

Objective: to compare dual tobacco users (conventional smoking and traditional tobacco chewing in paan) with single tobacco users (cigarette smokers or tobacco chewing in paan alone) using psychosocial, health and nicotine dependence parameters. Methods: cross-sectional survey of 325 randomly sampled adult Bangladeshi men living in Tower Hamlets, a multiply disadvantaged area of London (UK). The study questionnaire used previously validated questions and was translated into Bengali. Interviews were conducted at respondents' homes. Results: Sample mean age was 40.7 years (95% CI 40. 2, 41. 2 years). Older respondents reported poorer health, more chronic illnesses, lower levels of educational attainment, higher unemployment and a higher degree of residential overcrowding compared to younger respondents. Dual tobacco users were likely to be older (OR=1.06, 95% CI 1.02,1.09), have wives who chewed tobacco in paan (OR 8.41, 95% CI 1.94,43.92) and smoked more cigarettes during the first few hours of the day (OR=2.67, 95% CI 1.09-6.54) compared to smokers alone. Compared to tobacco in paan chewers alone dual tobacco users were less likely to chew more in the first few hours of a day (OR=16.54, 95% CI 1.34,206.05) and carry a paan box with them when they were away from home (OR=21.23, 95% CI 1.63,275.38). The results of a multinomial logit for socio-economic and health risk factors for tobacco use confirmed that compared to smokers alone dual tobacco users were more likely to have a wife who chewed tobacco in paan (RR=6.03, 95% CI 1.99,18.26). Conclusions: concurrent tobacco use was common in this random sample of Bangladeshi men. These findings require special skills in the provision of tobacco cessation advice by health care professionals, including the dental team.