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• W1982644619 abstract "Accurate estimation of mean number of cigarettes smoked per day is vital for the planning and assessment of smoking cessation programmes, and allocation of scarce resources. Gary Giovino and colleagues' estimation of various tobacco burden indicators1Giovino GA Mirza SA Samet JM et al.Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys.Lancet. 2012; 380: 668-679Summary Full Text Full Text PDF PubMed Scopus (515) Google Scholar is commendable. However, their estimation of mean cigarettes smoked per day and its comparison across countries is questionable. The study estimated mean cigarettes smoked per day by considering the use of manufactured or country-specific hand-rolled cigarettes. But these two products differ in terms of smoking pattern and nicotine content per stick, which could affect the number of cigarettes smoked per day.2Laugesen M Epton M Frampton CM Glover M Lea RA Hand-rolled cigarette smoking patterns compared with factory-made cigarette smoking in New Zealand men.BMC Public Health. 2009; 9: 194Crossref PubMed Scopus (51) Google Scholar, 3Malson JL Sims K Murty R Pickworth WB Comparison of the nicotine content of tobacco used in bidis and conventional cigarettes.Tob Control. 2001; 10: 181-183Crossref PubMed Scopus (82) Google Scholar Culture and regulatory environment could also affect mean cigarettes smoked per day.4Fagerstrom K Time to first cigarette; the best single indicator of tobacco dependence?.Monaldi Arch Chest Dis. 2003; 59: 91-94PubMed Google Scholar Giovino and colleagues' findings would not represent overall smoking frequency for India and Bangladesh owing to the predominance of bidi smoking in these regions. Moreover, Giovino and colleagues wrongly estimate the mean cigarettes smoked per day for India and Vietnam as 2·1 and 10·9, respectively, owing to incorrect denominator selection. The actual mean number of cigarettes smoked per day in India and Vietnam are 6·2 and 13·5, respectively.5Centers for Disease Control and PreventionGlobal Tobacco Surveillance System data (GTSSData).http://apps.nccd.cdc.gov/gtssdata/Ancillary/DataReports.aspx?CAID=2Google Scholar Further, Giovino and colleagues estimate that the mean number of cigarettes smoked per day is higher in women (7·0) than men (6·1) in India. But this abnormal finding could be due to misreporting and weak survey methods. There is limited knowledge about rolled-cigarette use in India, a problem that is not helped by inadequate piloting of the Global Adult Tobacco Survey (GATS) in India. Recording of smokeless products under “other smoking tobacco use” in the GATS questionnaire indicates a weak survey technique. GATS-India data indicate that most of the dual users smoked either equal or higher numbers of manufactured cigarettes than rolled cigarettes.5Centers for Disease Control and PreventionGlobal Tobacco Surveillance System data (GTSSData).http://apps.nccd.cdc.gov/gtssdata/Ancillary/DataReports.aspx?CAID=2Google Scholar This finding is unlikely and points towards misreporting. The above points indicate the need for standardisation of the indicator of mean cigarettes smoked per day and improvement of survey methods. We declare that we have no conflicts of interest. Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveysThe first wave of GATS showed high rates of smoking in men, early initiation of smoking in women, and low quit ratios, reinforcing the view that efforts to prevent initiation and promote cessation of tobacco use are needed to reduce associated morbidity and mortality. Full-Text PDF Prevalence and patterns of tobacco use in Asia – Authors' replyZhiqiang Wang and Jin Ma share our stated concerns1 about under-reporting of tobacco use in countries where smoking is socially unacceptable for some groups, especially women and young people. We think, however, that their assertion of severe under-reporting in all of Asia is unsubstantiated by the two studies cited, one in China and another in Korea.2 Tobacco use varies across Asia. Additionally, the methods of their unpublished study in Shanghai are not sufficiently described and Shanghai is not representative of China. Full-Text PDF" @default.
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• W1982644619 date "2012-12-01" @default.
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• W1982644619 title "Prevalence and patterns of tobacco use in Asia" @default.
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• W1982644619 doi "https://doi.org/10.1016/s0140-6736(12)62108-4" @default.
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