{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T05:48:08Z","timestamp":1782193688767,"version":"3.54.5"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tobacco use remains a major preventable cause of disease in low- and middle-income countries, and nationally representative evidence distinguishing tobacco product types in Myanmar remains limited. We aimed to provide nationally representative, product-specific estimates of smoked, smokeless, and dual tobacco use among individuals aged 15\u201349 years in Myanmar using data from the 2015\u20132016 Demographic and Health Survey, and to examine sociodemographic inequalities in tobacco use patterns.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a cross-sectional secondary analysis using data from the 2015\u20132016 Myanmar Demographic and Health Survey (MDHS), the most recent nationally representative household survey with adult tobacco use indicators in Myanmar. The sample included 17,620 individuals aged 15\u201349 years with complete tobacco use data. Tobacco use was classified as no use, smoked tobacco only, smokeless tobacco only, or dual use. Weighted descriptive statistics and survey-weighted multivariable multinomial logistic regression adjusted for age, sex, education, residence, marital status, occupation, wealth quintile, and mass media exposure were used to assess associations with sociodemographic factors, reporting adjusted relative risk ratios (ARRRs) with 95% confidence intervals (CIs). Statistical significance was defined as\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 86.3% reported no tobacco use; smoked tobacco use was 13.0%, whereas smokeless (0.4%) and dual use (0.3%) were rare. Older age (40\u201349 years) was associated with higher likelihood of smoked tobacco use (ARRR = 3.58, 95% CI 2.70, 4.74,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). Men had a substantially higher likelihood of smoked tobacco use (ARRR = 21.96, 95% CI 18.38, 26.22,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and higher likelihood of smokeless and dual tobacco use, although estimates for the latter categories should be interpreted cautiously because of small numbers. Higher education and wealth were associated with lower likelihood of smoked tobacco use. Being not currently married or cohabiting was associated with higher likelihood of smoked tobacco use and dual use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Smoked tobacco predominated among adults aged 15\u201349 years, while smokeless (chewing tobacco and snuff) and dual use were rare. Marked sociodemographic inequalities highlight the product-specific, equity-oriented tobacco control and updated surveillance. Findings should be interpreted considering the cross-sectional design, potential self-report bias, limited generalizability due to restriction to individuals aged 15\u201349 years, and the 2015\u20132016 survey period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1839321","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T05:26:30Z","timestamp":1782192390000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Sociodemographic inequalities in product-specific tobacco use in Myanmar: a nationally representative study of the 2015\u20132016 demographic and health survey"],"prefix":"10.3389","volume":"14","author":[{"given":"Soe Sandi","family":"Tint","sequence":"first","affiliation":[{"name":"Global Health and Chronic Conditions Research Center, Chiang Mai University","place":["Chiang Mai, Thailand"]},{"name":"Department of Family Medicine, Faculty of Medicine, Chiang Mai University","place":["Chiang Mai, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanittha","family":"Thaikla","sequence":"additional","affiliation":[{"name":"Research Institute for Health Sciences, Chiang Mai University","place":["Chiang Mai, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aung","family":"Tun","sequence":"additional","affiliation":[{"name":"Tun Khit Foundation","place":["Yangon, Myanmar"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kong Sam","family":"An","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Substance Abuse, Ministry of Health","place":["Phnom Penh, Cambodia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiraporn","family":"Laoung-on","sequence":"additional","affiliation":[{"name":"Research Institute for Health Sciences, Chiang Mai University","place":["Chiang Mai, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hlaing Thaw","family":"Dar","sequence":"additional","affiliation":[{"name":"Public Health and Community Medicine Department, IMU University School of Medicine","place":["Kuala Lumpur, Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myo Zin","family":"Oo","sequence":"additional","affiliation":[{"name":"Research Institute for Health Sciences, Chiang Mai University","place":["Chiang Mai, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"s1","DOI":"10.1136\/tc-2024-058717","article-title":"Tobacco control in low-income and middle-income countries: findings from WHO FCTC investment cases","volume":"33","author":"Tauras","year":"2024","journal-title":"Tob Control."},{"key":"B2","unstructured":"Tobacco: World Health Organization.\n          \n    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