Public Health Investigators and Student Publish in International Journal

By Heather Riefsnyder

Four Loma Linda University School of Public Health investigators on the National-Institutes-of-Health-funded Tobacco Control Leadership Training research grant and a public health doctoral student published an article on tobacco use in Cambodia in the December 2009 issue of the international Bulletin of the World Health Organization together with investigators from the Ministry of Health and World Health Organization in Cambodia, as well as Adventist Development and Relief Agency (ADRA) Cambodia.

The most significant finding in the report is the high rate of older Cambodia women using smokeless tobacco, says lead author Pramil Singh, Dr.P.H., associate professor of epidemiology. Seventeen percent of Cambodian women use chewing tobacco — more than 560,000. Prevalence increases as women age; about half of rural women over the age of 50 have the habit.

The reason for its high use, especially in rural areas, tends to be the influence of older relatives, appetite reduction, and the alleviation of morning sickness during pregnancy.

“For tobacco control programmes, this poses the immediate challenge of ‘educating’ rural women against long-held cultural, familial and traditional medical beliefs,” the report states. “Tobacco control programmes to decrease tobacco use in pregnant women may also need to include health education for their older relatives and health-care providers.”

The findings were reported by news sources including The Washington Post and The Associated Press.

The report is based on the largest study ever undertaken of tobacco use in Cambodia. It was conducted in 2005–06 by LLU School of Public Health, the National Institute of Statistics (Ministry of Planning, Cambodia), the National Center for Health Promotion (Cambodia), and ADRA Cambodia.

The report can be read online at http://www.who.int/bulletin/volumes/en/ under the link for past issues. In addition to Singh, School of Public Health investigators Jayakaran Job, M.D.; Linda Hyder Ferry, M.D., M.P.H.; and Synnove Knutsen, Ph.D., M.D., M.P.H,. and epidemiology doctoral student Jaime Lopez are authors on the paper. There were three additional authors not from LLU.