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
[email protected]
[email protected]
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
[email protected]