Better access to cessation services can curb smoking rates

Regardless of country and local context, improving access to cessation services appears to reduce smoking rates, according to a survey of South Asian countries.

Drawing from nationally representative surveys, the researchers investigated factors related to cigarette smoking among men in Afghanistan, Pakistan, Nepal, India, and Maldives. Participants’ age ranged from 15 to 49 years. The outcome of interest was cigarette smoking prevalence.

Maldives had the highest prevalence of smoking at 41.2 percent, while this was lowest in Pakistan at 20.1 percent. Afghanistan and India saw prevalence rates of approximately 22.0 percent, while a third of men from Nepal smoked.

Of note, smoking rates increased with age except in Maldives, where men 20–29 years old were the strongest smokers. Prevalence rates were also highest among men who were not working.

Pooled analysis of all included countries confirmed that age was an important indicator of smoking, with men aged 40–49 years being more than 400-percent more likely to be cigarette users than 15–19-year-olds (adjusted odds ratio [OR], 4.61; p<0.001). Meanwhile, higher education and household wealth were significantly protective against smoking.

Country-specific analyses revealed minor variations in these trends, though it remained broadly true that age, wealth, education, and access to information were strong predictors of smoking prevalence.

“The government and policymakers should design and implement interventions targeting high-risk groups to reduce the burden of cigarette smoking,” the researchers said. “Smoking cessation support services should be promoted in South Asian countries to accelerate quitting rate among elder groups.”