Impact of Smoking on Morbidity and Attributable Costs among Reproductive-Aged Women in Dharan, Nepal

Abstract

Smoking among reproductive-aged women poses a significant public health challenge, particularly in developing countries like Nepal, where tobacco use persists despite widespread awareness of its risks. This descriptive cross-sectional study investigated the morbidity and costs attributable to smoking among 384 reproductive-aged women (15-49 years) in selected wards of Dharan, Nepal. Data were collected (January to March, 2023) through face-to-face interviews using a semi-structured questionnaire and purposive non-probability sampling. Descriptive statistics (frequencies, percentages, and means) and inferential statistics (chi-square tests, p< 0.05) were employed for analysis. The findings revealed that 35.4% of participants were aged 26-35 years, 93% were married, and 61.7% had a monthly family income of NPR 10,000-20,000. Cigarettes were the primary tobacco product used (61.7%), with 60.7% smoking 1-5 sticks per day and spending NPR 10-20 daily (57.6%). Over half (50.8%) initiated smoking at a young age, and while all participants acknowledged the harms of smoking, respiratory issues were the most commonly perceived consequence (77.9%). A substantial 83.6% reported health problems attributed to smoking, including hypertension, low birth weight, premature birth, asthma, and diabetes. Annual health expenditures were below NPR 10,000 for 83.3% of respondents. Significant associations were found between morbidity and age (p< 0.05), diabetes/stroke and daily cigarette consumption (p< 0.05), and smoking expenditure and age (p< 0.001). Younger women appeared to bear a disproportionate burden. These findings underscore the urgent need for targeted interventions, such as smoking cessation programs integrated into prenatal care, to mitigate the health and economic consequences of tobacco use.