{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:01:52Z","timestamp":1767193312557,"version":"3.48.0"},"reference-count":37,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,8,12]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the association between tobacco use and marital living arrangements among married women in Pakistan using data from the 2017\u20132018 Pakistan Demographic and Health Survey (PDHS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional secondary analysis of nationally representative survey data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The analysis used data from 561 clusters across all regions of Pakistan, collected through a complex stratified sampling design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 11,669 married women aged 15\u201349 years with complete information on tobacco use and living arrangements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary outcome measure<\/jats:title>\n                    <jats:p>Self-reported current use of any tobacco product.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No significant association was found between marital living arrangement and tobacco use (adjusted prevalence OR (aPOR), 0.969; 95%\u2009CI, 0.585 to 1.605). However, higher odds of tobacco use were associated with being illiterate (aPOR, 1.51; 95%\u2009CI, 1.05 to 2.16), having more children (aPOR, 1.07; 95%\u2009CI, 1.02 to 1.14) and, living in Baluchistan (aPOR, 4.98; 95%\u2009CI, 2.20 to 11.26).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Living arrangements were not significantly associated with tobacco use, sociodemographic and reproductive health indicators showed strong associations. Interventions should target illiteracy, reproductive stress and region-specific behaviours.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099643","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:25:26Z","timestamp":1756315526000},"page":"e099643","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["A cross-sectional analysis of the link between tobacco use and marital living arrangements among Pakistani women: insights from Pakistan Demographic and Health Survey 2017\u20132018"],"prefix":"10.1136","volume":"15","author":[{"given":"Mahreen","family":"Hirani","sequence":"first","affiliation":[{"name":"Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5448-0786","authenticated-orcid":false,"given":"Sehar","family":"Tejani","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3545-0808","authenticated-orcid":false,"given":"Jawaria Mukhtar","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"2025123106481832000_15.8.e099643.1","unstructured":"World Health Organization . 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