Smoking prevalence, determinants, knowledge, attitudes and habits among Buddhist monks in Lao PDR

Between March and September 2006, 390 monks were interviewed, using questionnaires, to assess smoking prevalence including determinants, knowledge and attitudes. Data entry was performed with Epi-Info (version 6.04) and data analysis with SPSS version 11. Descriptive analysis was employed for all independent and dependent variables. Chi-square or Fisher's exact test were used for categorical variables to compare smoking status, knowledge, attitudes and province. Logistic regression was applied to identify determinants of smoking. Daily current smoking was 11.8%. Controlling for confounding variables, age at start of monkhood and the length of religious education were significant determinants of smoking. The majority of the monks 67.9% were in favor of the idea that offerings of cigarettes should be prohibited and that they should refuse the cigarettes offered to them (30.3%) but, in fact, 34.8% of the monks who were current smokers accepted cigarettes from the public.Some monks were smokers, whilst they, in fact, should be used as non-smoking role models. There was no anti-smoking policy in temples. This needs to be addressed when setting up smoke-free policies at temples.Every six seconds, someone dies of a smoking-related disease [1]. By 2030, more than 80% of tobacco-related deaths will be in low- and middle-income countries [2]. The tobacco epidemic is one of the greatest public health challenges not least in the Western Pacific and South East Asia.The Lao People's Democratic Republic (Lao PDR) is one of the poorest countries in the world with a Gross National Income (GNI) per capita of $ 935 or less, life expectancy at birth of 63 years and under-five mortality rate of 75 [3,4]. Tobacco is listed as the third most important agricultural crop in Lao PDR and this is, obviously, in conflict with any tobacco control policy [5]. Daily smoking among males is 50% and females 10% [2] and this is the first study on smoking among Buddhist monks in Lao PDR.More than 85% o