Prevalence and determinants of areca nut use among pregnant women in India

ABSTRACT

Background

Areca nut is the fourth most commonly used substance worldwide after nicotine, alcohol, and caffeine. Women in many countries use it in cultural and religious ceremonies. The use of areca nut is harmful to health; but when women consume it during pregnancy, it exerts several harmful effects on the fetus. This paper examines the prevalence and determinants of areca nut use among pregnant women in India.

Methods

Data from the Global Adult Tobacco Survey-2, India, are used for analysis (N = 1403 pregnant women). Multiple classification analysis and multivariate logistic regression model were applied to estimate the effect of various determinates.

Results

About 16% pregnant women used areca nut in any form in India. Areca nut use with (24%) and without (13%) tobacco was higher among scheduled tribes. Region, caste, religion, place of residence, educational attainment, occupation, and economic status are found to be important determinants of areca nut use.

Conclusion

More specific programs which can effectively reduce the use of areca nut among pregnant women should be adopted. Programs related to prevention of areca nut use should be expanded effectively through health awareness interventions during pregnancy, including media messages, and involvement of frontline health workers, especially focusing on the socio-economically backward groups.

KEYWORDS:

• Areca nut
• pregnant women
• India

Acknowledgments

This paper is an output of the GATS 2 follow-up study, School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India. This initiative was supported by the Ministry of Health and Family Welfare, Government of India; the World Health Organization; the Centers for Disease Control and Prevention, Atlanta, and the CDC Foundation. Financial support was provided by the Bloomberg Initiative to Reduce Tobacco Use through the CDC Foundation with a grant from Bloomberg Philanthropies. We are thankful to TISS, Mumbai, for providing an opportunity for in-depth research with the Global Adult Tobacco Survey, India, data through the series of Scientific Writing Workshops. We thank the GATS 2 Follow-up Study Team and the Resource Persons for their suggestions that significantly assisted in improving this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics statement

The GATS India data set is available in the public domain from CDC and are de-identified. All the Global Adult Tobacco Surveys were approved by ethical boards of survey countries and CDC, Atlanta. Study protocols and survey materials for GATS-1 were approved by the Ethics Review Committee and Institutional Review Board (IRB) of the International Institute for Population Sciences, Mumbai. Study protocols and survey materials for GATS-2 were approved by the Ethics Review Committee and IRB of Tata Institute of Social Sciences, Mumbai. Consent was obtained from all participants. Parent or guardian consent was obtained for interviews of minors aged 15–17 years.

Data availability statement

The data set used in the study is available in the public domain at the Centers for Disease Control and Prevention, Atlanta website.

Additional information

Funding

Financial support was provided by the Bloomberg Initiative to Reduce Tobacco Use through the CDC Foundation with a grant from Bloomberg Philanthropies.