Nearly four-fifths of estimated 1.1 million smokers live in low or middle-income countries. We aimed
to provide national estimates for Nepal on tobacco use prevalence, its distribution across demographic, socioeconomic and spatial variables and correlates of tobacco use.
Methods: A secondary data analysis of 2006 Nepal Demographic and Health Survey (DHS) was done. A
representative sample of 9,036 households was selected by two-stage stratified, probability proportional to size
(PPS) technique. We constructed three outcome variables ‘tobacco smoke’, ‘tobacco chewer’ and ‘any tobacco use’
based on four questions about tobacco use that were asked in DHS questionnaires. Socio-economic, demographic
and spatial predictor variables were used. We computed overall prevalence for ‘tobacco smoking’, ‘tobacco
chewing’ and ‘any tobacco use’ i.e. point estimates of prevalence rates, 95% confidence intervals (CIs) after
adjustment for strata and clustering at primary sampling unit (PSU) level. For correlates of tobacco use, we used
multivariate analysis to calculate adjusted odds ratios (AORs) and their 95% CIs. A p-value < 0.05 was considered as
significant.
Results: Total number of households, eligible women and men interviewed was 8707, 10793 and 4397
respectively. The overall prevalence for ‘any tobacco use’, ‘tobacco smoking’ and ‘tobacco chewing’ were 30.3%
(95% CI 28.9, 31.7), 20.7% (95% CI 19.5, 22.0) and 14.6% (95% CI 13.5, 15.7) respectively. Prevalence among men was
significantly higher than women for ‘any tobacco use’ (56.5% versus 19.6%), ‘tobacco smoking’ (32.8% versus 15.8%)
and ‘tobacco chewing’ (38.0% versus 5.0%). By multivariate analysis, older adults, men, lesser educated and those
with lower wealth quintiles were more likely to be using all forms of tobacco. Divorced, separated, and widowed
were more likely to smoke (OR 1.49, 95% CI 1.14, 1.94) and chew tobacco (OR 1.36, 95% CI 0.97, 1.93) as compared
to those who were currently married. Prevalence of ‘tobacco chewing’ was higher in eastern region (19.7%) and
terai/plains (16.2%). ‘Tobacco smoking’ and ‘any tobacco use’ were higher in rural areas, mid-western and far
western and mountainous areas.
Conclusions: Prevalence of tobacco use is considerably high among Nepalese people. Demographic and
socioeconomic determinants and spatial distribution should be considered while planning tobacco contro