Determinants of cigarette/bidi smoking among youth male in rural Mymensingh of Bangladesh: A cross-sectional study

Background Smoking cigarette/bidi, is a serious health threat, causes preventable premature morbidity and mortality. Higher prevalence of smoking among the youth hampers a country’s development, as the youth are the main drivers of socio-economic development. An effective understanding of factors associated with youth smoking is precious to prevent youth smoking. This study aims to identify the determinants of smoking cigarette/bidi among the youth male of the rural areas of Mymensingh district in Bangladesh. Methods The primary data from the project “Knowledge, awareness and practices among youth smokers in Trishal Upazila under Mymensingh district: A micro-survey study”, funded by the Research and Extension Center, Jatiya Kabi Kazi Nazrul Islam University, Bangladesh was utilized in the current study. The data consists of 385 youth males aged 15–24 years who were interviewed face-to-face from the rural areas of Mymensingh district in Bangladesh. Univariate distribution, chi-square tests, and binary logistic regression model were employed to identify the factors associated with smoking cigarette/bidi among the youth male. Results The prevalence of smoking cigarette/bidi among the youth male is 40.3% [95% CI: 35.0%-45.0%]. Age, occupation, monthly income, family’s monthly income, cigarette/bidi smoking status of father, brother and close friends, and knowledge about harmfulness of smoking are revealed as the determinants of cigarette/bidi smoking. For instance, the odds of being smoker increases with the increase in age (Odds ratio [OR]: 1.33 [1.17–1.51]). Business owner is less likely (OR: 0.15 [0.03–0.68]) to smoke than the day labourer. Having smoker fathers (OR: 2.51 [1.39–4.53]), smoker brothers (OR: 2.88 [1.39–5.96]), smoker friends (OR: 9.85 [5.85–1.27]) are significantly associated with smoking cigarette/bidi. Conclusion As the first study, it provides the determinants of cigarette/bidi smoking among youth male of the rural areas of Mymensingh district in Bangladesh. Relevant authorities are suggested to consider the study’s findings and recommendations to revise the existing smoking policies so that smoking among youth can be prevented for future development of the country.


Background
Smoking cigarette/ bidi, is a serious health threat, causes preventable premature morbidity and mortality. Higher prevalence of smoking among the youth hampers a country's development, as the youth are the main drives of socio-economic development. An effective understanding of factors associated with youth smoking is precious to prevent youth smoking. This study aims to identify the determinants of smoking cigarette/bidi among the youth male of the rural areas of Mymensingh district in Bangladesh.

Methods
Data came from a secondary source. A total of 385 youth male aged 15-24 years were interviewed face-to-face from the rural areas of Mymensingh district in Bangladesh. Univariate distribution, chi-square tests, and binary logistic regression model were employed to identify the factors associated with smoking cigarette/bidi among the youth male.

Results
The prevalence of smoking cigarette/bidi among the youth male is 40.3%. Age, occupation, monthly income, family's monthly income, cigarette/ bidi smoking status of father, brother and close friends, and knowledge about harmfulness of smoking are revealed as the determinants of cigarette/ bidi smoking. For instance, the odds of being smoker for those aged 18-20 years is 1

Conclusion
As the first study, it provides the determinants of cigarette/ bidi smoking among youth male of the rural areas of Mymensingh district in Bangladesh. Relevant authorities are suggested to consider the study's findings and recommendations to revise the existing smoking policies so that smoking among youth can be prevented for future development of the country.

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Univariate distribution, chi-square tests, and binary logistic regression model were employed 37 to identify the factors associated with smoking cigarette/bidi among the youth male.

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The prevalence of smoking cigarette/bidi among the youth male is 40.3%. Age, occupation,  Tobacco use is a significant public health concern. Globally, more than 7 million 61 people die due to direct tobacco use, and around 1.2 million non-smokers die due to being 62 exposed to second-hand smoke [1]. All forms of tobacco are harmful, and there is no safe 63 level of exposure to tobacco [1]. Cigarette/ bidi smoking is the most common form of tobacco university male students are found to initiate smoking at an average age of 17.8 years [3].

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Evidences demonstrate that majority of the people try their first cigarette before the age of  Bangladesh has made a considerable progress in socio-economic and demographic 83 indicators over the last few decades [9]. And, the socio-economic and demographic indicators 84 are progressing in the right path to achieve the desired level of prospective socio-economic 85 development in the country. However, the progress could stay behind the desired level due to 86 the use of tobacco among the youth, as the use of tobacco has high impact on growing   socio-demographics, and shows the variation in percentage of smokers by socio-192 demographics. A significant association between cigarette/ bidi smokers and age group was 193 found; percentage of cigarette/ bidi smokers increase with the increase in age (p<0.001).

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Respondents who are with below secondary education, day labourers, with monthly income 195 BDT<5,000, with monthly family income BDT>25,000, financially independent from their 196 family are more likely to smoke cigarette/ bidi than their counterparts. Respondents whose 197 fathers, brothers and close friends are cigarette/ bidi smokers are also more likely to smoke 198 cigarette/ bidi than the respondents whose fathers, brothers and close friends are non-  Table 3 shows the results of binary logistic regression model that yields the odds of

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There is an independent positive association of personal income with smoking among 245 adolescents aged 14-17 years in six European countries [32]. Economic inequality has also 246 direct correspondence with tobacco use [33]. Youth male with personal income, compared to 247 those with no income, have higher likelihood of cigarette/ bidi smoking in the current study,