Prevalence and determinants of tobacco use in a highly literate rural community in southern India.

BACKGROUND: The adverse effects of tobacco use on the health of an individual are well known. It is essential to identify factors leading to tobacco use to plan strategies to limit its use. Education is known to influence the prevalence of tobacco use. We aimed to determine the prevalence and patterns of tobacco use in a rural community with a high literacy rate and to examine the socioeconomic and demographic correlates of tobacco consumption in the area. METHODS: A cross-sectional survey using personal interviews was carried out on 832 individuals > 15 years of age. The prevalence of current daily use of tobacco was used as the outcome measure. The main analytical methods used were chi-square test and multiple logistic regression analysis. RESULTS: The prevalence of tobacco use was 17.5%, being common among older persons, the lower socioeconomic group and those who were less educated. Tobacco was used predominantly in smokeless forms (chewing, snuff or both). The commonest reason cited for initiating tobacco use was to relieve toothache. CONCLUSIONS: Our findings in this rural community suggest that improvement in the educational and socioeconomic status may lead to a decline in the use of tobacco. Health education to improve dental hygiene may also help to reduce tobacco use in this community as it is predominantly used in the chewing form.

Antioxidants, lipid peroxidation and lipoproteins in primary hypertension.

The antioxidants and lipid peroxidation products are being extensively studied because of their potential importance and pathogenetic role in several non-communicable diseases like cardiovascular diseases and cancer, but the data on hypertension is scanty. Therefore, the present study aimed to assess the levels of lipid peroxidation and antioxidants besides dislipidemia changes among 32 newly diagnosed male hypertensives by comparing them with an equal sample of normotensives. Significant increase in serum lipid peroxide levels and decrease in antioxidant enzyme superoxide dismutase and vitamins E and A were observed among hypertensives than the controls. Hypertensives had higher total cholesterol, low-density lipoprotein cholesterol, triglycerides, body mass index and low high-density lipoprotein cholesterol levels than normotensives. The percentage prevalence of hypercholesterolemia, hypertriglyceridemia, low high-density lipoprotein cholesterol and obesity was higher in study subjects. Obese hypertensives had significantly higher levels of lipid peroxides and lipids with no change in antioxidant status than normal-weight hypertensives. Our results suggest that hypertensive patients may have elevated lipid peroxidation, lipids and reduced protection from antioxidants, which may contribute to the propensity in such patients to develop cardiovascular diseases, and to correct this, antioxidant supplementation besides weight reduction may be helpful to reduce the severity of burden.

Influence of parental literacy and socio-economic status on infant mortality.

The influence of parental literacy and socio-economic status (SES) on infant mortality rate (IMR) was studied. This report is only a part of much larger community-based prospective study conducted to determine the factors influencing infant mortality in Dakshina Kannada district of Karnataka, by the Department of Community Medicine, Kasturba Medical College, Manipal, with the financial assistance form IDRC, Canada. A total of 12,857 livebirths during the period of October 1, 1991, to September 30, 1992, where registered and followed up for one year. There were 391 infant deaths which gives an IMR of 30.4 per 1,000 livebirths. Univariate analysis and subsequent stepwise multiple logistic regression analysis revealed that, literacy and SES have a very significant role in reducing IMR.