recent findings and methods
Transkript
recent findings and methods
Turkish Tobacco, Alcohol and Drugs General Population Survey, 2011 Assoc. Prof. Dr. Mustafa N. İLHAN TUBİM & Gazi University Aim of the survey It’s aimed to know the scope of, type and attitude towards alcohol, tobacco and drug abuse among general population in Turkey 2 Methods-Design and Sampling Study was conducted among a cross-sectional sample representing Turkey in 2011 Study was carried out by face-to-face interview at addresses taken from TURKSTAT (Turkey Statistics Institute) in cities determined TUBİM General Population Survey workgroup 8,045 successful interviews was done as a result of going to 18,319 houses in 25 cities which was obtained from TUIK Response rate (43,9%)… 3 Methods-Data Collection Distribution of urban/rural and the quota according to age groups was determined in study Study was conducted only in urban areas in provinces which has rural population rate less than 5% 4 Methods-Not to Interview Table 1: Reason for not to interview with household, Turkey, 2011. Reasons % Address not found/Insufficient address 3,0 Rejected by apartment officer 1,9 No person at home/At home but not opening the door 36,3 Not residence (summerhouse, officies, agencies, empty house) 1,2 Interview takes a long time - Interrupted 4,4 Too sick to participate in - Refused 0,5 Too busy - Refused 31,3 Worried about safety/security - Refused 2,2 Definitely not attending survey - Refused 16,4 Not interested in subject - Interrupted 1,0 Questions are very inconvenient - Interrupted 0,9 5 Other - Refused 0,9 Methods-Data Collection Study was applied by an independent research company in field and data was delivered unproccessed to TUBİM Preliminary information letter was sent to houses by TUBİM GPS Working Group before visiting in order to minimize the problems would arise Field application of the study was done between the dates September – December 2011, last checks and data entry was completed on February 2012, reporting was completed June 2012 6 Sayın İlgili, Gazi Üniversitesi Tıp Fakültesi Halk Sağlığı Ana Bilim Dalı ve Psikiyatri Ana Bilim Dalı Öğretim Üyeleri tarafından “Türkiye’de Genel Nüfusta Ruh Sağlığı Açısından Koruma ve Önleme amacıyla Tütün, Alkol ve Madde Kullanımına Yönelik Tutum ve Davranış Araştırması” adlı bir anket gerçekleştirecektir. Ankete katılmak üzere seçilen haneler Türkiye’deki tüm ikametgah adreslerinden Türkiye İstatistik Kurumu (TÜİK) tarafından rasgele seçilmiş olup, bu adreslerde ikamet eden 15 ve 64 yaş arasında kişiler araştırmaya dahil edilmiştir. Her hanede kiminle görüşme yapılacağını seçmek için tekrar bir rastlantısal seçim yapılmaktadır. Hane halkı üyesinin seçimi görüşmeci ziyarete geldiğinde yapılacaktır. Sizin adresiniz de seçilenler arasında olduğundan, seçilen hane halkı üyesinin bu önemli çalışmada görüşme yapması beklenmektedir. Anketi yanıtlamak için yaklaşık 10 dakikanızı ayırmanızı umut ediyoruz. Görüşmeci size göstereceği bir kimlik kartı taşıyor olacaktır. Alınan tüm bilgiler kesinlikle gizli tutulacak ve sadece Genel Nüfusta Ruh Sağlığı Açısından Koruma ve Önlemeye Yönelik çalışmalarda değerlendirilecektir. Araştırma sonucunda sadece Türkiye Geneli sonuçlara ulaşılabilecek olup, il, ilçe ya da mahalle ya da hane düzeyinde herhangi bir sonuca ulaşılmayacaktır. Ankete vermiş olduğunuz cevaplarla ülkemizin geleceğini tehdit eden ve giderek büyüyen sağlık sorunları hakkında bilgi toplanacaktır. Toplanan bu bilgiler problemlerin önlenmesinde ve çözülmesinde kullanılacak olup, Türkiye açısından çok büyük önem taşımaktadır. Şimdiden verdiğiniz samimi cevaplara teşekkür ediyoruz. Sunduğunuz bilgiler Araştırma Ekibi dışından hiç kimseye açıklanmayacaktır. Araştırma verilerinin daima gizli kalacağı konusunda sizi temin ediyoruz. Anket başında sorulan kişisel bilgileriniz anketi uygulayan kuruluşun Dünya Standartlarında uygulama yapabilmesi için gerekli olup, anketin tamamlanmasından 1 gün sonra imha edilecektir. Anket esnasında geçebilirsiniz. ve sonrasında doğabilecek olan sorunlarınız için bizimle irtibata Yardımınızı umarak, teşekkürlerimizi sunuyoruz. Saygılarımızla, Doç. Dr. Mustafa N. İlhan Prof. Dr. Zehra Arıkan Gazi Üniversitesi Tıp Fakültesi Gazi Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı Psikiyatri Anabilim Dalı mnilhan@hotmail.com zarikan54@gmail.com Tel: 0312.2024639 Tel: 0312.2025450 7 Methods-Questionnaire Questionnaire used was developed from the EMCDDA Model Questionnaire with some changes The questionnaire was used in Ankara 2009 pilot study and after preforming applied to household aged between 15 and 64 years 8 Descriptive Results • A total 8045 people were reached, 49,0% (3943 persons) of the participants were female, 51,0% (4102 persons) male with a mean age of 36,10±13,38 years and median 34,00 years • 39,5% (3177 persons) were primary school graduate, 24,1% (1935 persons) high school graduate , 16,9% (1360 persons) secondary school graduate • 44,1% (3545 persons) were housewives, 14,6% (1175 persons) worker/servant, 11,1% (889 persons) student • 71,3% (5736 persons) were married 9 Results About Tobacco Use • 51,8% (4169 persons) of the participants have tried a a tobacco product as cigarette, cigar, pipe, water pipe, etc. (lifetime prevalence) • The mean age for the first time to use tobacco product is 19,77±13,40 years and the median 17,00 years Table 2: The lifetime, last 12 months and last month tobacco use prevalences of general population, Turkey, 2011. Prevalence (%) (n) Lifetime 51,8 4169 Last 12 months 35,1 2820 Last 1 month 33,2 2668 10 Results About Tobacco Use • The median of last 1 month tobacco products use is all of the 30 days • Branded cigarettes ranked as the first choice while hand-rolled cigarette and waterpipe ranked as 2. and 3. • 40,1% of females and 63,1% of males tried tobacco and, 23,8% of females and 42,1% of males have been using tobacco still 11 Results About Alcohol Use • 28,3% (2280 persons) of the participants have tried alcoholic beverages (lifetime prevalence) • The mean age for the first time to use alcoholic beverages is 20,93±9,90 years and the median 19,00 years Table 3: The lifetime, last 12 months and last month alcoholic beverages use prevalences of general population, Turkey, 2011. Prevalence (%) (n) Lifetime 28,3 2280 Last 12 months 14,3 1153 Last 1 month 10,1 813 12 Results About Alcohol Use • Of the participants used alcoholic beverages in last 1 month 1,5% indicated used 1-3 times per week, 1,3% used every week and 75,3% drinked 1-2, 19,6% drinked 3-4 standard alcoholic beverages (300cc beer, a double raki, a glass of wine) • 2,5% (203 persons) of the participants drink alcoholic beverage regularly and first choice of the 82,9% is beer • 12,3% of the participants drinking alcoholic beverages were defined as dependent according to CAGE measuring alcohol dependence 13 Results About Prescripted Drug Use • 10,5% of the participants used sedative/tranquilizer drugs (lifetime prevalence) • The mean onset age of prescrited drug use is 34,66±14,42 years and the median is 33,00 years • Of the participants used prescipted drugs, 68,7% indicated using these drugs every day, 98,3% used the drug oral, 61,3% used without a physician advice, 94,6% provided by prescription Table 4:The lifetime, last 12 months and last month prescripted drug use prevalences of general population,Turkey, 2011 Prevalence (%) (n) Lifetime 10,5 843 5,1 408 Last 12 months 14 Last 1 month 3,7 300 Results About Substance Use Table 5: The lifetime substance use prevalences of participants, Turkey, 2011*. Cannabis Ecstasy Amphetamine Captagon Metamphetamine Crack Cocaine Heroin LSD Solvent Magic mushroom Methadone Opioid-Opium Anabolic Steroid Other Total Lifetime Prevalence (%) 0,7 0,1 0 0 0 0 0 2,0 2,8 (2,7)** Number 56 7 1 2 1 2 4 160 233 (217)** *Asked by showing cards with street names. **There are also people using more than one substance, the answer ‘other’ was accepted15as using substance, a total of 217 people are using substance. Results About Lifetime Substance Use by Age Groups Table 6: Distribution of lifetime substance use status of general population by age groups, Turkey, 2011. Lifetime Substance Use Age group Yes % No % 15-24 2,9 97,1 25-44 2,8 97,2 45-64 2,3 97,7 p=0,323 16 Results About Lifetime Substance Use by Gender Groups Table 7: Distribution of lifetime substance use status of general population by gender, Turkey, 2011. Lifetime Substance Use Gender Yes % No % Male 2,6 97,4 Female 3,5 96,5 p=0,078 17 Results About Lifetime Substance Use by Education Groups Table 8: Distribution of lifetime substance use status of general population by education, Turkey, 2011. Lifetime Substance Use Education Yes % No % Illiterate 2,6 97,4 Primary School Graduate 2,4 97,6 Secondary School Grad. 3,2 96,8 High School Graduate 2,6 97,4 University Graduate 3,1 96,9 p=0,521 18 Results About Lifetime Substance Use by Marital Status Table 9: Distribution of lifetime substance use status of general population by maritual status, Turkey, 2011 . Lifetime Substance Use Maritual Status Yes % No % Single 3,8 96,2 Married 2,4 97,6 Widow/Divorced/ 1,5 98,5 - 100,0 Living separated Live-in/ Polygamist p=0,005 19 Results About Lifetime Substance Use by Longest Lived Settlement Groups Table 10: Distribution of lifetime substance use general population by groups of the longest lived settlement, Turkey, 2011. Lifetime Substance Use Yes % No % City centrum 2,6 97,4 County seat 2,9 97,1 Village/Town 2,7 97,3 p=0,850 20 Results About Lifetime Substance Use by Income Groups Table 11: Distribution of lifetime substance use status of general population by ıncome groups, Turkey, 2011. Lifetime Substance Use Yes % No % Less than ~220 EU* 5,6 94,4 220-450 EU 2,2 97,8 451-900 EU 2,6 97,4 901 EU and over 2,9 97,1 p=0,001 *TR minimum wage 21 Status of Substance Use by Tobacco, Alcohol and Prescripted Drug Use Table 12: Distribution of lifetime substance use by lifetime, last 12 months and last 30 days tobacco, alcohol and precripted drug use, Turkey, 2011. 22 Lifetime Substance Use Yes % No % Lifetime Tobacco Yes No Alcohol Yes No Pr. Drug Yes No Last 12 Months Tobacco Yes No Alcohol Yes No Pr. Drug Yes No Last 30 Days Tobacco Yes No Alcohol Yes No Pr. Drug Yes No 3,0 2,3 3,9 2,2 3,3 2,6 97,0 97,7 96,1 97,8 96,7 97,4 3,6 2,2 5,4 2,2 3,4 2,7 96,4 97,8 94,6 97,8 96,6 97,3 3,6 2,3 6,0 2,3 3,0 2,7 96,4 97,7 94,0 97,7 97,0 97,3 p=0,046 p=0,001 p=0,260 p=0,001 p=0,001 p=0,344 p=0,001 p=0,001 p=0,715 23 Results About Cannabis Use • Cannabis use was analysed separately, since the cannabis use was determined as the most frequent used substance and the other substance’s use remained less Table 13: Participants’ lifetime, last 12 months and last 1 month cannabis use prevalences of general population,Turkey, 2011. Prevalence (%) (n) Lifetime 0,7 56 Last 12 months 0,3 23 Last 1 month 0,2 13 24 Results About Cannabis Use • The mean onset age of cannabis use is 20,89±3,99 and the median is 20,00 years • 76,8% of the participants used cannabis did not use cannabis in last month • Cannabis users obtain cannabis from hemp plant (buds, clover, grass) and mostly using with tobacco • 0,2% of the society state using cannabis regularly and almost half of this group use cannabis 4-7 times a week • More than half of the people used cannabis stated that they could quit cannabis after trying while the 25 1/5 could not Results About Cannabis Use • Last used cannabis is provided from family and friends mostly and used at a friends home • Half of the cannabis users appraise the providing cannabis within 24 hours as “easy” • 14% of the cannabis users think that the use got out of control, again 14% state that the probability of skipping one dose causes anxiety, 19,3% feel anxiety about cannabis use and 35,1% want to quit cannabis use • 86,7% of cannabis users state being drunk for 1-4 hours daily after using and 7,3% state being drunk for at least 6 hours every day 26 Results About Cannabis Use • 9,1% of cannabis users declare not being able to stop using every day, 10,9% declare not being able to fulfill what is expected from him, 9,1% state using again to begin the day, 18% state feeling regret and 35,1% state experiencing concentration problems • 6,9% of cannabis users injured because of his or others’ cannabis use • 16,9% of cannabis users were suggested to reduce or quit by relative, friend or physicians 27 Results About Crime Perception Table 14: Distribution of general population’s crime perception about substance use, Turkey, 2011. Perception of Substance % Dependence Rather guilty 14,9 Rather ill 48,4 Neither guilty nor ill Both guilty and ill Undecided 6,0 25,9 4,7 28 Results About Population’s View Table 14: Distribution of general population’s view about cannabis use, Turkey, 2011. 29 Results About General Population’s Tolerance About Cannabis Use Table 15: Distribution of general population’s tolerance about cannabis use, Turkey, 2011. Trying ecstasy for 1-2 times Trying heroin for 1-2 times Smoking 10 cigarettes a day Drink alcohol for 1-2 times a week Smoking cannabis occasionally Tolerate Partially ing Tolerate ing % % 0,5 1,6 Absolutely not tolerating % 92,2 Not know % 5,6 0,3 0,7 95,3 3,7 8,1 16,4 73,1 2,4 7,4 12,9 77,1 2,7 0,6 1,0 95,3 3,1 30 Results About Risk Perception Table 16: Distribution of general population’s risk perception about tobacco, alcohol and substance use, Turkey, 2011. Smoking one or more packs of cigarettes a day Drink 5 or more alcohol at the weekend Smoking cannabis occasionally Trying ecstasy for 1-2 times Trying cocaine or crack for 1-2 times Riskfree % 0,3 Mildrisk % 2,3 Intermed iate-risk % 9,6 Heavyrisk % 86,0 Not know 0,8 3,0 11,7 82,0 2,4 0,1 0,2 1,6 95,8 2,3 0,2 0,5 2,3 92,3 4,7 0,1 0,3 1,8 93,6 4,1 % 1,8 31 Conclusion & Suggestions • According to study, tobacco and alcohol use stay stable in our country… • For last 10 years, there is a similar status in age of on-set and dependence level… • However water pipe use must be paid attention among the young !.. • Prescripted drug abuse seems to be an important problem and detailed studies should be done about this issue… 32 Conclusion & Suggestions • This study shows that a slight increase trend in addictive substance use although it is not a big problem in our country such as in western countries and it is thought that protection and prevention from addictive substances should be done… • A systematic approach like: investigating the general population’s Prevalences periodically (as this study did) to evaluate the effect of protective and preventive interventions will be done and methods will be apllied should be developed with necessary arrengements, would be appropriate… 33 Thank you for attention !... Assoc.Prof.Dr. Mustafa N. İLHAN TUBİM & Gazi University mnilhan@gazi.edu.tr