Smoking among males in a low socioeconomic area of Karachi

Approximately half of the families in Pakistan reported having at least one smoker in 1992. Smokers were less educated, poorer and more likely to come from a rural background than non-smokers. The proportion of family earnings in poor families with marginal incomes, may be substantial. We conducted this survey to determine the prevalence of cigarette smoking in males over 15 years of age in Azam Basti, an urban squatter settlement of Karachi where 31% of the children less than 5 years old were malnourished. A pretested, structured questionnaire was administered to males aged fifteen years and above, from randomly selected homes in Azam Basti. In our sample of 102 persons the respondents were 38 years old on average, and earned about Rs. 4,500 (US $130) per month. Persons with 10 or more years of education were thrice as likely to have never smoked as compared to those with less than ten years of schooling, (OR = 3.6, 95% confidence interval 1.2, 11.4). Current smokers were more than twice as likely as non-smokers to have monthly household incomes less than Rs. 5000 (US $140) (OR = 2.4, 95% confidence interval 0.8, 7.3). Smoking is common in urban squatter settlements in Pakistan. Parental smoking and its relationship with malnutrition in children under five is not well documented or publicized, even though there is evidence that it has a contribution. We propose that primary health care programs consider smoking prevention and cessation as community based interventions.