|Year : 2008 | Volume
| Issue : 1 | Page : 33-38
Pattern and frequency of substance abuse in urban population of Lucknow
SC Tiwari1, P Kumar2, R Tripathi3
1 Head, Dept. of Geriatric Mental Health, KGMU, LKO, India
2 Lucknow, India
3 Sr. Research Fellow, Lucknow, India
|Date of Web Publication||13-May-2010|
S C Tiwari
Head, Dept. of Geriatric Mental Health, KGMU, LKO
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: The urban Lucknow community was studied during a project "A study to evolve material for prevention of drug/alcohol/tobacco (substance) abuse through social marketing" funded by Council of Science & Technology, Lucknow. The paper presents pattern and frequency of substance abuse in urban population of Lucknow based upon it. Method: Two mohallas of a ward from Lucknow Municipal Corporation were selected randomly. A total of 842 heads of the households (out of 5420 members) were studied using Semi Structured Socio demographic data-sheet and Proforma from WHO-ICMR a collaborative study on narcotics and psychotropic drugs. Data was analyzed using percentage, mean and S.D. Results: Out of 5420 subjects 34.31% (30.22% males & 4.09% females) were found to be substance abusers. Majority of subjects used tobacco (68.17% smoking, 65.17% eating). Conclusion : Majority of subjects were regular users constituted 73.65% tobacco smokers and 74.38% eaters/chewers, 62.38% alcoholics were experimenters and amongst those who were psychotropic drug abusers, 64.28% were dependant.
Keywords: Substance abuse, Urban Population
|How to cite this article:|
Tiwari S C, Kumar P, Tripathi R. Pattern and frequency of substance abuse in urban population of Lucknow. Ind Psychiatry J 2008;17:33-8
Substance uses are serious health problems in many countries including India because of the associated health hazards. The World Health Organization (WHO) estimates that 4.9 million death (8.8%) and 59.1 million disability adjusted life years (DALYs) (4.1%) are attributable to tobacco every year. Unless the current trends are reversed, the figure is expected to rise to ten million deaths per year by the 2020s or early 2030s, with 7 million of these deaths occurring in developing countries, mainly in China and India (http://www.who). Worldwide, about one fifth of all deaths attributed to tobacco occur in India, like more than 8,00,000 people die and 12 million become ill as a result of tobacco use every year .The deaths attributed to tobacco in India are expected to rise from 1.4%of all deaths in1990 to 13.3% in 2002 (Patel, 1999). Worldwide,1.8 million deaths and 58.3 million DALYs are attributed to the use of alcohol is estimated to cause about 20%-30% of esophageal cancer, liver cancer, cirrhosis of the liver homicide epilepsy and motor vehicle accident. Review of the health hazards of exposure to environmental tobacco smoke shows that it damages the respiratory tract of adults, adversely affects the cardiovascular system and results in lung cancer (Wiebal,1997).
Smoking causes vast spectrum of diseases, many of which could result in death. There are over 50 diseases that are caused, increased on exacerbated by smoking (Gupta &Sinha2004). Globally, approximately 47% of men and 12% of women smoke. In developing countries 48% of men smoke compared with 7% of women, while in developed countries 42% of men and 24% of women smoke (Ahuja,1981). In a study on urban population Meena et.al. (2002) reported, prevalence of alcohol use is 19.78%, and on analysis of alcohol users for other substance abuse it was found that 16.81% users were smokers also. 6.89% had the habit of taking Pan masala/Zarda. 2.04% alcohol users were taking Soolfa (ganja) also alongwith alcohol. Frequency of opium and cannabis abuse was found to be 1.51% and 1.18% respectively. A prevalence survey of tobacco use in Karnataka and Utter Pradesh in India Carried out on study sample of 30,000 persons aged over 10 years in each of the two states, found an overall prevalence of any kind of tobacco as 29.6% in Karnataka and 34.6% in Utter Pradesh. The prevalence of ever use of tobacco in Utter Pradesh was 45.4 % among urban men, 8.2% among urban women, 51.2% among rural men and 9.3%among rural women (ICMR.2006). Permeshwaran and Massiuddin (1981)studied 7 cities in the country and found alcohol to be the commonest (20%) and tobacco (10%) followed by pain killers. The use of tobacco was more prevalent among boys (14%) than girls (3%).
A numbers of studies have been done in rural (Goswami et al.2005; Gupta et al.1995; ICMR, 2006) and urban population (Meena et al, 2002; Permeshwaran & Massiuddin,1981) having substance and most of the studies focus on prevalence and prevention of these substances. Therefore, it is needed to find out the pattern and frequency of substance use in urban population to plan effective interventional strategies. The investigator expected that the findings would provide useful information to professionals working in the field of de-addiction and broadening their outlook from the point of view of frequency and pattern of substance abuse.
| Methods|| |
The project on "A study to evolve material for prevention of drug/alcohol/tobacco (substance) abuse through social marketing" was carried out by the Department of Psychiatry, CSM Medical University, Lucknow. The sample was derived by initially locating all the 110 wards of Lucknow municipal area. Out of this one ward (Nishatganj) was selected by the process of simple random selection. Two mohallas viz. Paper Mill Colony and Badshah Nagar Railway Sachivalaya Colony were selected randomly from this ward of the Lucknow. A door to door survey was carried out. Informed consent from the subjects was taken. The subjects aged 17 years and above were interviewed. The information about other members was obtained from these heads of the families. Out of 842 house holds there were only 31 female heads and nearly 85% females refused for interview, saying that their views did not differ from the husband and information has already been provided by their husband. In remaining about 15% who agreed for interview but they were accompanied either by the husband or another male members of the households. So it was decided to include senior most males from there households in place of females to bring uniformity in the sample and to eliminate problems in statistical analysis. The identified heads of the households were studied using (A) Semi Structured Socio Demographics Datasheet and (B) Proforma developed by WHO-ICMR study on narcotics drugs and psychotropic drugs. The substance users were categorized into three categories, (i) experimenters who took substance once a week or less often, (ii) regular who took substance daily or several times a week, (iii) dependants or addict who could not live without substance (Ahuja 1981). The generated data was analyzed using percentage, mean and SD whenever applicable using SPSS V 7.5.
| Results|| |
[Table 1] shows age wise distribution of the heads of the families. The mean age of heads of the families were found to 44.7 7years.
[Table 2] shows socio-demographic profile of heads of the families. Most of these were Hindus (78.97%), comprising of general caste (80.99%), backward caste (13.06%) and schedule caste (5.93%). Majority of the heads of the families were graduates (56.41%) while only 0.23% were illiterate. In the entire study area majority (83.27%) consisted of service (office worker), 7.48% were businessman and only 1.30% were unemployed. Most of the community lived in nuclear family set-up (72.68%) and belonged to monthly income group range 2501-5000 Rs. Majority of the subjects (90.38%) were married and the percentage of unmarried and widowed was more or less equal (3.32% and 3.68% respectively).
[Table 3] shows that out of total 5420 subjects 1638(30.22%) males and only 222(4.09%) females were substance abusers whereas 1590(28.33%) males and 1970(36.35%) females were non-abusers in urban community of Lucknow. It was found that 34.31% of the total population were substance abusers.
[Table 4] shows gender wise distribution of pattern of substance abuse in urban community. Out of 1860 subjects 72.04% males and 39.64% females were tobacco eaters, 62.27% males and 87.39% females were tobacco chewers, 4.21% males and 20.72% females used to take cannabis (Ganja/Charas/ Bhang),13% males and 2.25% females used to take alcohol, 2.56% males and 6.75% females used to take Affim(Opium) and 0.49% males and 2.70% females used to take psychotropic drugs.
[Table 5] shows the pattern of substance abuse by heads of the family (62.35%) heads of the family were abusing substances. It was observed that majority of them were tobacco abusers (smoking 69.99% and eating 53.90%) followed by alcohol (21.41%). Only 0.95% heads of the families were taking psychotropic drugs and 1.52 were taking (opium).
[Table 6] Shows the frequency of substance used by the abusers in the urban community. The experimenters were the lowest in the community (12.85%) fallowed by dependants (13.48%), & number of regulars was maximum in the community (73.65%)out of 1268 tobacco smokers. Further out of 1214 tobacco abusers consuming by chewing/eating/were mostly regulars (74.38%)followed by dependants(16.63%) and experimenters (8.97%).Out of 218 alcohol abusers most of the subjects were experimenters (62.38%),followed by dependants (27.98%) and only 9.63% were taking alcohol regularly .Out of 57 opium users most of them were experimenters 71.92%, dependants & regulars were more equal (15.78% & 12.98% respectively).Out of 14 psychotropic drug users maximum 64.28%were dependents and rest of the 35.7% were regulars . No one was found to be experimenter for the psychotropic drugs.
| Discussion|| |
Present study was conducted to find out the pattern and frequency of substance abuse in urban community of Lucknow. The results show that 30.22% males and 4.09% females of the urban community of Lucknow were substance abusers. A study conducted by Mohan et al (2001) reported 40.9% substance abuse in males and out of them the prevalence of tobacco, alcohol, cannabis and opiods use among males was 27.6, 12.6, 0.3 and 0.4 percent respectively and 2% women was substance abusers and majority of them were tobacco abusers. About 10 % more males and 2 times females were found to be substance abusers in Delhi, which is different from our finding. It may be because of massive urbanization, industrialization, population movements, breaking of joint family set ups in metro cities rather than other city. Present study reveals 62.35% heads of the families were substance abusers, of them majority (69.99% & 53.99%) were using tobacco in the form of smoking or eating. 21.15% heads of the family were consuming alcohol, this finding is in fewer of the study of Meena et al (2002), Permeshwaran and Massiuddin(1981), Sethi & Trivedi (1979), Thacore & Saxena (1971) and Ray et al.(2001). Only 2.85% heads of the family was consuming cannabis, 1.52% consuming affim (opium) and .95% were consuming psychotropic drugs. These findings are supported by the results of a National household survey in India conducted in March 2000 and November 2001 (Ray et. al 2001). In this study alcohol abuse 21.4%, cannabis abuse 3%, heroin abuse 0.2% and other opiates 0.1 % was found.
Merton et al (1971) suggested that people who are in relatively unfavorable competitive positions for attaining their goals legitimately experience strains and frustration which ultimately motivate them to drug abuse. However the recent spurt of massive urbanization, industrialization, population movements, breaking of joint family set ups are the prime factors, perhaps responsible for this problem. A number of other related and inter related factors such as unemployment, disappointments, frustration lack of health education, festivals and traditions are other phenomenon contributing to this.
Our study calculated a prevalence pattern of 34.31% in urban community for all kinds of substance abuse.
Ahuja1981 in a study of urban college students found that of total abusers 10.5% were regulars and 88.7% were experimenters. In alcohol abuse 20% were found to be dependants and 11.3% were regulars and 86.8% were experimenters. Among the users of other drugs 19% were dependants, 3.5% regulars and 9.4% experimenters. Mohan et al (2001) reported regular abusers to be highest among tobacco abusers (95.5%) followed by opium(57.8%) and cannabis (29%).In comparison to result of Ahuja (1981) we found that out of total abusers in urban area 15.97% were experimenters followed by regulars(65.80%) and dependant 18.22%. In Ahuja's5 1981study percentage of experimenters were maximum 88.7% whereas in our study regulars were maximum (65.88%). Thus the figures for urban experimenters are nearly similar in both the studies. Our findings are also supported by the study of Mohan et a1(2001).
There does not seem to be a uniform pattern of substance abuse as reported by different studies. It appears that methodological differences, different operational definitions of substance abuse included in the study, reporting biases etc, may account for these differences. Our study has shown less number of users as compared to that reported by Deb and Jindal17 1974and more than the figures reported by many others (Ahuja (1981), Meena et al(2002) and Permeshwaran & Massiuddin(1981). )The findings are none the less corroborating with present day scenario of substance abuse morbidity.
| Future Direction|| |
Results of this study and other various studies regarding frequency and pattern of substance abuse are not in a consensus (there is no uniform methodology for the collection of data). Often, the drug abuse research fail to follow uniform methodology due to non availability of the definition of the various types of drug abuse. Therefore, there is a need to conduct such type of more researches to find out actual pattern of substance use in the community with improved methodology, operational definition of substance abuse and considering socio-cultural and socio-economic background of the communities. Thus, there is to develop uniformly acceptable definition of various aspect of drug abuse in India, So that uniformity in research could be brought.
| Acknowledgement|| |
The authors express their gratefulness to Council of Science & Technology, Lucknow for providing financial assistance to carry out the study on "A study of evolve material for prevention of drug/alcohol/tobacco (substance) abuse through social marketing". The authors are thankful to the project team for their interest and help in collecting the basic data needed for the project and to the key informants who provided the necessary cooperation & help.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]