Knowledge, attitude, practice, cardiovascular risk and current tobacco use among adults in Pyin Oo Lwin Township, Mandalay Region, Myanmar

Background: Tobacco consumption is a major health risk behavior in Myanmar, a low-income country in Southeast Asia. The lack of effective policy and public health measures causes many chronic diseases leading to premature mortality. This study was conducted to determine the prevalence of smoking and smokeless tobacco use, the association between socio-demographic characteristics, knowledge, and attitudes about tobacco use, and current tobacco use, and the relationship between Framingham cardiovascular disease risk and different types of tobacco use among adults in Pyin Oo Lwin, Myanmar. Methods: A cross-sectional study was conducted among 430 adults aged 18 years and older, both genders, in Pyin Oo Lwin, Myanmar. Results: The mean age was 40.2 years and 70.5% were male. Tobacco consumption is common in the form of smoking (39.5%) and smokeless tobacco use (32.6%).  Among the current smokers and current smokeless tobacco users, the majority were male (97.1% and 85.0% respectively). Men had 13 times the odds of being current tobacco users compared to women. Gender, education, occupation, and attitude toward tobacco use were identified as significant factors of current tobacco use (p<0.050). Current exclusive smokers are 6.15 times more likely to have cardiovascular diseases compared to non-current users (OR=6.149, p<0.001). Conclusions: Health education campaigns should be conducted to change the attitude toward tobacco use among adults in Myanmar. Smoking cessation, regular physical activity, and reduced alcohol and salt intake should be encouraged to prevent cardiovascular disease.