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Reading: Money Gone Up in Smoke: The Tobacco Use and Malnutrition Nexus in Bangladesh

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Original Research

Money Gone Up in Smoke: The Tobacco Use and Malnutrition Nexus in Bangladesh

Authors:

Muhammad Jami Husain ,

Centers for Disease Control and Prevention, Atlanta, GA
About Muhammad Jami
PhD
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Mandeep Virk-Baker,

National Cancer Institute, National Institutes of Health, Rockville, MD
About Mandeep
PhD, MPH, RD
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Mark Parascandola,

National Cancer Institute, National Institutes of Health, Rockville, MD
About Mark
PhD, MPH
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Bazlul Haque Khondker,

Department of Economics, University of Dhaka, Dhaka, Bangladesh
About Bazlul Haque
PhD
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Indu B. Ahluwalia

Centers for Disease Control and Prevention, Atlanta, GA
About Indu B.
PhD, MPH
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Abstract

Background

The tobacco epidemic in Bangladesh is pervasive. Expenditures on tobacco may reduce money available for food in a country with a high malnutrition rate.

Objectives

The aims of the study are to quantify the opportunity costs of tobacco expenditure in terms of nutrition (ie, food energy) forgone and the potential improvements in the household level food-energy status if the money spent on tobacco were diverted for food consumption.

Method

We analyzed data from the 2010 Bangladesh Household Income and Expenditure Survey, a nationally representative survey conducted among 12,240 households. We present 2 analytical scenarios: (1) the lower-bound gain scenario entailing money spent on tobacco partially diverted to acquiring food according to households' food consumption share in total expenditures; and (2) the upper-bound gain scenario entailing money spent on tobacco diverted to acquiring food only. Age- and gender-based energy norms were used to identify food-energy deficient households. Data were analyzed by mutually exclusive smoking-only, smokeless-only, and dual-tobacco user households.

Findings

On average, a smoking-only household could gain 269-497 kilocalories (kcal) daily under the lower-bound and upper-bound scenarios, respectively. The potential energy gains for smokeless-only and dual-tobacco user households ranged from 148-268 kcal and 508-924 kcal, respectively. Under these lower- and upper-bound estimates, the percentage of smoking-only user households that are malnourished declined significantly from the baseline rate of 38% to 33% and 29%, respectively. For the smokeless-only and dual-tobacco user households, there were 2-3 and 6-9 percentage point drops in the malnutrition prevalence rates. The tobacco expenditure shift could translate to an additional 4.6-7.7 million food-energy malnourished persons meeting their caloric requirements.

Conclusions

The findings suggest that tobacco use reduction could facilitate concomitant improvements in population-level nutrition status and may inform the development and refinement of tobacco prevention and control efforts in Bangladesh.
How to Cite: Husain, M.J., Virk-Baker, M., Parascandola, M., Khondker, B.H. and Ahluwalia, I.B., 2017. Money Gone Up in Smoke: The Tobacco Use and Malnutrition Nexus in Bangladesh. Annals of Global Health, 82(5), pp.749–759. DOI: http://doi.org/10.1016/j.aogh.2016.07.005
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Published on 08 Mar 2017.
Peer Reviewed

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