A Comparison between the Knowledge and Attitude of Tobacco Users and Never-users: A Community Based Cross-sectional Study

Context: Tobacco use is an epidemic that causes substantial mortality and morbidity. Despite the known risks, individuals continue to use tobacco. An understanding of the knowledge and attitudes regarding tobacco use will help in devising newer and updated guidelines for controlling this epidemic. Aims: To compare the knowledge and attitude of tobacco users and never tobacco users from the same neighbourhood in order to ascertain the degree of difference between their knowledge and attitude. Settings and Design: This community based cross-sectional study was conducted amongst all the persons aged 15 years or above and residing in the catchment areas of four AWCs under the Anandi and Chakla sub-centres. Methods and Material: Between April 2018 and March 2019, two hundred and twelve subjects were sampled by cluster random sampling and interviewed from the catchment areas of four AWCs under the Anandi and Chakla sub-centres. Knowledge and attitude was tested through a pre-tested semi structured questionnaire. Statistical analysis used: Chi-square was used to assess the crude association between sample characteristics and tobacco use. Binomial logistic regression analysis was used to investigate factors associated with a tobacco use. Results: The overall prevalence of tobacco use was 44.3%. Univariate analysis found association between tobacco use and being male[chi(2) = 89.69(1), p = <.001], friends using tobacco [chi(2) = 73.72 (1), p = <.001] and knowledge about tobacco deaddiction centre [chi(2) = 10.27(1), p = .001]. A Mann Whitney U test also showed significant association between tobacco use and age, mean knowledge score and mean attitude sore. A binomial logistic regression analysis at the end identified that only mean attitude scores were significantly predicting tobacco use [Wald=5.437 (1), p= .02, CI .000066 to 0.216] Conclusions: The prevalence of tobacco use was high, and this prevalence increases with age and is especially high among males. Having a friend who uses tobacco is an important determinant of tobacco use and tobacco users need to be informed and supported to quit tobacco with the help of tobacco de-addiction centres. Awareness of COTPA act among the respondents is low. The attitude regarding tobacco use and prevention among the current tobacco users was found wanting.