TOBACCO AND ALCOHOL USE AMONG CHRONIC DISEASE PATIENTS IN CAMBODIA, MYANMAR AND VIETNAM.

The aim of this study was to explore the prevalence of tobacco and alcohol use and to determine the factors associated with tobacco and alcohol use among chronic disease patients in Cambodia, Myanmar and Vietnam. A cross-sectional survey was conducted among 4,803 adult chronic disease patients (mean age 49.3 years; SD=16.5) recruited systematically from health facilities. Fifteen point five percent of those studied were current smokers, 14.5% current smokeless tobacco users, 20.7% daily tobacco users (smokers or smokeless tobacco), 9.3% problem drinkers and 4.1% both daily tobacco users and problem drinkers. Having been diagnosed with hypertension, chronic obstructive pulmonary disease (COPD), liver disease, and dyslipidemia were positively associated with daily tobacco use; liver disease, gout and other musculoskeletal conditions, kidney disease, and dyslipidemia were positively associated with problem drinking. On multivariate logistic regression analysis, socio-demographics (being male, older age, lower education, coming from Myanmar, being single, divorced or widowed, rural residence and part-time employed), problem drinking and having two or more chronic health conditions were associated with daily tobacco use. Socio-demographics (being male, younger age, coming from Vietnam, being married or cohabiting), daily tobacco use and not having depressive symptoms were found to be associated with problem drinking. High prevalences of daily tobacco use and problem drinking were found among chronic disease patients and several socio-demographic, disease specific, and other health risk behavior factors were identified which can guide substance use intervention programs for this population.