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Sylhetisation, dependence and ambivalence: a qualitative exploration of paan use amongst older Bangladeshi women in London

Mahendran, J (2015) Sylhetisation, dependence and ambivalence: a qualitative exploration of paan use amongst older Bangladeshi women in London. PhD thesis, Bath Spa University.

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Abstract

This thesis introduces a novel and alternative way of understanding paan addiction among Bangladeshi women by exploring their lived experiences. There is growing medical evidence that paan, a mixture of betel leaf, areca nut, tobacco and white lime, is injurious to health, causing cancer, oral disease and addition (WHO, 2004). Paan use is prevalent and visible among the Bangladeshi community in East London. However, paan dependence is principally examined through the dominant medical model, which prioritises the scientific and pharmacological aspects. Research has yet to examine paan dependence from the user's perspective, which limits health and social care professionals from understanding the practice, the determinants of the habit and the elements contributing to its continued use. Understanding the user perspective would assist in designing and delivering appropriate and targeted interventions. There are no similar studies of this nature into paan use and therefore this study developed a theoretical framework by examining literature pertaining to migration, biographies and inequalities in health. METHOD: An ethnographic study was conducted and data collected through extensive fieldwork followed by in-depth interviews with thirty Bangladeshi women in Tower Hamlets, East London, who have continuously used paan over a number of years. Participants were recruited through purposive sampling. Interview data was analysed thematically using grounded theory techniques (Glazer and Strauss, 1967) and then triangulated to compare and crosscheck the consistency of the research findings. FINDINGS: Key research findings indicate that while health discourses have explained paan use simply as a result of physical addition to tobacco, exploring the biographical, historical and social context of paan use developed a deeper understanding of how the participants constituted the experience and meaning of paan addiction. Four key themes emerged - physical and psychological addiction, availability and social acceptance of paan chewing, lack of involvement in the wider social environment and 'Sylhetisation', (a concept introduced by this thesis to describe how the Bangladeshi community have created an environment similar to that of Sylhet). The main recommendation is that an understanding of the sociocultural aspects of paan use may help greatly in developing more culturally specific paan cessation strategies within tobacco policies.

Item Type: Thesis (PhD)
Divisions: College of Liberal Arts
Date Deposited: 02 Jul 2015 16:49
Last Modified: 29 Apr 2016 14:11
URI: http://researchspace.bathspa.ac.uk/id/eprint/6274
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