Prevalence of chronic obstructive pulmonary disease and its association with tobacco smoking and environmental tobacco smoke exposure among rural population

Background: The prevalence of COPD is increasing in India. Only few studies have been conducted in rural areas of India to find out the prevalence of COPD and its relationship with tobacco smoking, environmental tobacco smoke (ETS) exposure and type of cooking fuel used. Hence the present study was undertaken with the following objectives:-

i) To find out the prevalence of COPD in adult subjects of 35 years and above.

ii) To determine the tobacco smoking, ETS exposure and type of cooking fuel used as an associated risk factor with COPD.

Material and methods: Field survey was conducted for COPD epidemiology in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore, India which covers a population of 44,387 residing in 71 villages using cluster sampling technique with the help of previously validated and standardized translated kannada (local language) version questionnaire for diagnosis of COPD among subjects of age 35 years and above. Spirometry was performed to all those who gave positive response to COPD and they were graded according to GOLD criteria. Results: Among 1400 subjects aged above 35 years, 693 (49.5%) were males and 707 (51.5%) were females. The overall prevalence of COPD was 4.36%. The prevalence among males and females were 5.32% and 3.41% respectively. The prevalence was found to be increasing with increase in age [p<0.001]. The prevalence of COPD among smokers (8.31%) was significantly higher compared to non smokers (3.04%) [p<0.001]. Among smokers the mean number of cigarettes/ bidis/ hookah smoked daily did not differ (p>0.05) between individuals without COPD and with COPD, whereas the mean number of years of smoking did differ (p<0.001) [Mann Whitney test]. The prevalence of COPD was significantly higher among those with ETS exposure (4.31%) compared to those without ETS exposure (2.02%) [p<0.05]. The prevalence of COPD among those who used smoke forming fuel and those who used non smoke forming fuel did not differ [p>0.05]. Conclusion: The prevalence of COPD was 4.36%. There was a significant association between tobacco smoking and ETS exposure with COPD.

 

Keywords: COPD (Chronic obstructive pulmonary disease), Prevalence,  Questionnaire, Spirometry, Tobacco smoking.