Exploring factors associated with smokeless tobacco use among urban Communities in Sri Lanka

Abstract

Smokeless tobacco is tobacco or a tobacco product that is used by means other than smoking which implies use of unburned tobacco in the finished products. These products are intended to be used orally, sucked, chewed, gargled or applied to the gums or tooth, while fire tobacco mixtures are usually inhaled into the nostrils. Chewing tobacco is a risk in getting oral cancers and pre-cancers. Other health risks of chewing tobacco include gum disease, tooth decay and tooth loss, and possible links to other cancers and cardiovascular disease. Informal observations reveal an increase in use of smokeless tobacco among youth and adolescence. Studies or health programs related to smokeless tobacco in Sri Lanka is scarce. This study attempted to explore factors associated with smokeless tobacco use among urban communities in Sri Lanka. Study design was qualitative in nature. Subjects / sample were selected based on snow ball sampling method. The study was conducted in Colombo district. Fourteen in-depth Interviews (n=14, including 8 males and 6 females) were conducted to collect data. Inquiries were made with regard to factors effecting initiation and continuing smokeless tobacco (Here, unseen determinant factors were especially taken into consideration). Saturation method was the guiding method of data collection and data were analyzed through framework analyzing method. The study found out the following factors associated with smokeless tobacco use among urban communities in Sri Lanka; Perceptions (‘Being with the gang’, as a youth style, Group action – Ganja Set, Pampara Set, Hanz Set), Expectancies (forget problems, keep the energy, and escape from the loneliness, to gain attraction, to gain pleasure, to keep wake up at night), distributors do it secretly acting as if they are engaged in other things, compare to other substitutions this is cheap, chemical effect cannot be seen by outsiders compared to other drugs, carelessness of parents, lack of knowledge about harmfulness of the product, peers – (not to be stigma, financial support), and certain qualities of the product (no bad smell). The study recommended an effective Health Promotion intervention to address these determinant factors.