METHODS: Questions about tobacco smoking, smokeless tobacco use, and betel quid chewing were used to create outcome variables such as tobacco smoking, smokeless tobacco use, and 'dual use' (tobacco use and betel quid chewing). Sex-stratified weighted prevalence rates, distribution by socio-demographic factors were presented. Association of demographic factors with tobacco and/or betel quid chewing was assessed by multinomial logistic regression.
RESULTS: Among men, prevalence (%) of tobacco use and betel quid chewing was 40.9 (95% CI 38.1, 42.1) and 58.9 (95% CI 56.3, 61.6) respectively. Among women tobacco use was 3.7 (95% CI 2.0, 4.3) and betel quid chewing 18.2 (95% CI 16.4, 20.0). Among men prevalence of either tobacco or betel quid and 'dual use' was 50.4 (95% CI 48.5, 52.3) and 25.0 (95% CI 23.1, 26.8) respectively, whereas among women the corresponding rates were 17.9 (95% CI 16.2, 19.6) and 2.0 (95% CI 1.6, 2.9). Smokeless tobacco use was low (Myanmar, prevalence of both tobacco use and betel quid chewing was high particularly among men. Tobacco control interventions should be strictly implemented and 'dual use' of both tobacco and betel quid should also be urgently addressed.
AIM OF THE STUDY: To assess wildlife for sale for medicinal purposes, and document their medicinal use at Kyaiktiyo, a pilgrimage site at a 1100m tall mountain, with many of the pilgrims climbing to the top. In addition we address legal issues relating to the production and sale of traditional medicine that contain legally protected animals.
MATERIAL AND METHODS: Four visits were made to Kyaiktiyo, Myanmar, between 2000 and 2017 to quantify animal parts on display and through discussions with vendors to obtain information on medicinal use of these parts.
RESULTS: Twenty-three species, mostly mammals, were recorded to be used for traditional medicine. The most common were Chinese serow Capricornis milneedwardsii, Asian elephant Elephas maximus, and Asiatic black bear Ursus thibetanus. Over 600 bodies or body parts were present. Combined, these parts purportedly provided cures or relief for at least 15 ailments or diseases. The most commonly mentioned treatment was that of using rendered animal fats/oils externally to relieve/cure aching joints or muscles. This treatment allegedly provides instant relief to pilgrims after an arduous climb up the mountain. Purported cures for various skin diseases was the next common use for the animal species on offer. Ten of the species observed for sale at Kyaiktiyo are listed as globally threatened, and 15 are protected and cannot be legally traded. Ambiguities in Myanmar's legislation mean that protected animals or their body parts cannot be traded, however traditional medicines can be made out of them provided rules relating to the manufacturing of traditional medicines are adhered to.
CONCLUSION: This study indicated that animals and their parts continue to be openly offered for sale at Kyaiktiyo to treat various illnesses. Despite these products potential medical, traditional or cultural importance, solutions have to been found on how to ensure that, in line with Myanmar's laws, use of traditional local medicine does not impede the conservation of imperilled species.