Use of substances: Reasons and cost of using substances in Karachi, Pakistan

Introduction Use of substances (pan, chaalia, ghutka, niswar) is associated with serious health risks. In Pakistan most people use substances from early years of life which keeps them on risk of short life span. The aim of this study was to estimate the costs of using these substances and to understand the reasons for using substances. Methodology This was a cross-sectional study conducted in two residential colonies in Karachi, Pakistan during 2008-2009. Pre-coded structured questionnaire was administered to collect the data on socio demographics, use of substance, costs and reasons for use of substances. Results From 124 randomly selected residents, 107 (86%) agreed to respond. All the selected participants were between the ages 10-71 years (mean±sd age 36.2±16.4). Daily use of substances was significantly higher among males (p<0.001). Further, the use was higher among adolescents than adults (p<0.001) and interestingly less educated consumed less than high educated (P=0.06). Males are spending significantly higher on substances; Rs. 37±11.5/day [Rs.930 or (US$13)/month] compared to females. Overall, 41% of the cost is spent on cigarettes followed by 27% on local ghutka respectively. The main reasons for using substances were peer pressure, easy availability of substances, stress, liking of taste and to treat toothache. Conclusion This study concluded that use of substances is higher among young males and they are spending substantial amount on those substances. To prevent this population, regular awareness campaigns may be held at community and school level so that, continuous re-enforcement make them to quit from using any substances.