Under-reporting of tobacco use among Bangladeshi women in England

J Public Health (Oxf). 2009 Sep;31(3):326-34. doi: 10.1093/pubmed/fdp060. Epub 2009 Jun 26.


Background: This study investigates the prevalence of under-reported use of tobacco among Bangladeshi women and the characteristics of this group.

Methods: The 1999 and 2004 Health Survey for England included 996 Bangladeshi women aged 16 years and above, 302 with a valid saliva sample and 694 without. The main outcome measure was the prevalence of under-reported tobacco use.

Results: Fifteen per cent of Bangladeshi women with a saliva sample under-reported their personal tobacco use. Under-reporters were very similar to self-reported users except for being much more likely to report chewing paan without tobacco (47% versus 9%, P < 0.001). Under-reporters differed significantly from cotinine-validated non-users in most respects. Regression analyses confirmed that under-reporters and self-reported users were similar in age, education level and exposure to passive smoking. Under-reporters were older and less educated than cotinine-validated non-users. Both self-reported users [odds ratio (OR): 0.11, 95% confidence interval (CI): 0.04-0.30] and cotinine-validated non-users (OR: 0.42, 95% CI: 0.20-0.89) were far less likely to report chewing paan without tobacco compared with under-reporters.

Conclusions: Contrary to our a priori hypothesis, under-reporters were not young, British-born, English-speaking women likely to be concealing smoking but resembled self-reported tobacco users except for being much more likely to report chewing paan without tobacco.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bangladesh / ethnology
  • Chi-Square Distribution
  • Cotinine / analysis
  • Cross-Sectional Studies
  • England / epidemiology
  • Female
  • Health Surveys
  • Humans
  • Interviews as Topic
  • Logistic Models
  • Odds Ratio
  • Piper betle
  • Prevalence
  • Regression Analysis
  • Saliva / chemistry
  • Self Disclosure*
  • Socioeconomic Factors
  • Tobacco Smoke Pollution
  • Tobacco, Smokeless*
  • Young Adult


  • Tobacco Smoke Pollution
  • Cotinine