Factors associated with tobacco use among working-age population in Mon state, Myanmar

Background: The tobacco epidemic is the leading cause of preventable death globally. Despite numerous studies on factors influencing tobacco use among working youths and adults, research remains limited on tobacco use and associated factors among the working-age population in urban and rural areas of Mon State. Objectives: To identify the factors associated with the tobacco use among the working-age population in Mon State, Myanmar. Methods: A cross-sectional study was conducted among 509 participants aged 18 to 60 years in Mon State, Myanmar, utilizing structured interviews. The associations between tobacco use and various factors were evaluated using multiple logistic regression analyses, with results reported as adjusted odds ratios (AORs) and corresponding 95% confidence intervals (CIs). Statistical significance was determined at a threshold of P <0.05. Results: The prevalence of tobacco use among the working-age population in Mon State was 45.58% (95% CI: 41.19-50.02). Factors significantly associated with tobacco use included male gender (AOR=10.04, 95% CI: 5.34-18.86), lower educational attainment; specifically uneducated or primary education (AOR=9.38, 95% CI: 4.43-19.81), secondary education (AOR=4.39, 95% CI: 1.97-9.76), and tertiary education (AOR=2.29, 95% CI: 1.17-4.49). Additional correlates included family influence (AOR=7.79, 95% CI: 4.33-14.02), peer pressure (AOR=2.92, 95% CI: 1.66-5.13), community influence (AOR=4.90, 95% CI: 2.85-8.59), moderately severe depression (AOR=5.27, 95% CI: 2.56-10.84), severe depression (AOR=3.67, 95% CI: 1.50-8.94), and neutral or positive perceptions of tobacco marketing (AOR=2.02, 95% CI: 1.16-3.49). Conclusion: About half of the study participants used tobacco. Being male, having lower educational status, having family influences, peer pressure, depression, and neutral and positive perception on tobacco marketing were associated with the higher risks of using tobacco. Therefore, it is important to make efforts in promoting of education, health education programs, effective tobacco control policies and mental health supports in addressing tobacco problems in Myanmar.