Tobacco Use Among Married Women in Nepal: The Role of Women’s Empowerment

This study documented the prevalence and correlates of tobacco use among women of reproductive age in Nepal using nationally
representative data. We utilized the 2006 Nepal Demographic and Health Survey that interviewed 10,793 women and 4,397 men.
We analyzed the couple’s data or households (N = 2,600) in which both husband and wife were interviewed. We examined the effects
of women’s empowerment—measured by education, employment, intra-household decisions, and age—on their tobacco use controlling
for other individual and household characteristics. Women’s empowerment had mixed effects on tobacco use. While women’s education
was inversely associated with their tobacco use, their age, employment and ability to make intra-household mobility decisions
were positively associated with smoking. Women with primary and beyond primary education were 48 and 92 % less likely to smoke
compared to women with no education, respectively. Tobacco use among women increased dramatically with age from 8 % in teen
years to 42 % in their forties. A 1 year increase in age increased the odds of tobacco use by 6 %. Women whose husbands smoked
were twice as likely to smoke. Nepal should not only restrict tobacco use in public places by implementing its Tobacco Control
and Regulatory Act of 2010 but also focus on encouraging smoke-free homes by increasing awareness about the health consequences
of tobacco use and secondhand smoke among populations most likely to smoke that include nearly all men, employed women, women
with low levels of education, women whose spouses smoke and those who are 30 and above in age. Additionally, a long term goal
should be to ensure at least 5th grade of education for all girls.