Factor associated with smokeless tobacco use in rural women and health systems readiness to address it

Date of Award


Document Type


Degree Name

Master of Science in Health Policy & Management (MSc Health Policy & Mgmt)


Community Health Sciences


Smokeless tobacco use has been found to be present across 116 countries making it a public health issue. Majority of the users are found to be South East Asia where a wide variety smokeless tobacco (SLT) products are available. Smokeless tobacco is linked to several life-threatening health hazards and there seems to be an increasing trend of usage of SLT among women. Pakistan having tobacco control policies is still not able to curb the increasing issue of SLT. Thus, there is a need to understand the factors associated with SLT usage among rural women and health systems readiness to address it. Study objectives: The study aimed to understand the factors associated of usage among rural women and their perception on health implications and view regarding SLT use. In addition to what the health systems readiness was to the growing issue of SLT usage among the population. Desk review of current tobacco policies was carried out to understand the policy environment around SLT. Methodology: Qualitative. techniques of exploratory approach, which included focus group discussions, key informant interviews and a desk review or national and sub national policies legislations and laws was carried out. Purposive sampling was used to carry out interviews with women who were SLT users and healthcare providers such as doctors, dentist and policymakers through a questionnaire. FDGs were carried out with SLT users who were women and KII were carried out with healthcare providers mainly doctors, dentists and policymakers. Official policy documents were downloaded from official website and reviewed. Results: Factors associated with SLT usage among rural women in Pakistan were identified. Factors such as motivation of usage, awareness of health hazards, current health issues from the user's perspective have been identified. On a community level affordability, accessibility, availability, preventive and control measures emerged. There was a lack of realization, readiness and action of health system through the healthcare providers and policymaker's perspective to address the issue of SLT usage. Pakistan lacks required policies. Legislations and law to address the growing problem of SLT usage among the population. Conclusion: There is a need to develop prevention and cessation measures to target factors associated with SLT usage among women. The health system should advocate and educate healthcare providers in dealing with problems associated with SLT usage by carrying out awareness sessions and trainings. Policies specifically addressing SLT should be developed in order to tackle and curb the issue of SLT usage among the population.

This document is available in the relevant AKU library