Increasing prevalence of smokeless tobacco consumption in the Northeastern region of India: An analysis of two rounds of Global Adult Tobacco Survey I and II (2009–10 and 2016–17)

Abstract

Abstract: INTRODUCTION: Tobacco claims over 8 million lives, with over 80% of the 1.3 billion users residing in low- and middle-income nations. India ranks highest in the proportion of users globally, notably in the Northeastern states. This paper aims to analyze the overall trends of smoking and smokeless tobacco (SLT) in the Northeast Region (NER) of India between the two rounds of the Global Adult Tobacco Survey (GATS) while analyzing the factors influencing tobacco used in the context of the region. MATERIALS AND METHODS: Descriptive analysis, estimation, and comparison of the prevalence of smoking and SLT were conducted for both rounds of GATS. The Chi-square test was employed to examine the association between variables such as gender, age, residence, education level, occupation, marital status, and caste while adjusting for GATS weight. RESULTS: The prevalence of smoking tobacco in GATS-II in NER is 19.3%, a decrease of 12% from GATS-I. While the use of manufactured cigarettes decreased by 33.7%, the use of bidi smoking and rolled tobacco in paper/leaf increased by 15.9% and 9.2%, respectively. The prevalence of SLT in GATS-II was 40.5%, a significant increase of 17% from GATS-I. While both genders exhibited increased tobacco usage, females experienced a particularly significant rise (18%) between the two survey rounds. No formal schooling, gender, rural residence, older age group, and occupation were significant factors in influencing the increased use of SLT. CONCLUSION: The prevalence of SLT consumption in the NER is on the rise, even as overall trends indicate a decrease in smoking tobacco. To effectively address this issue, tobacco should be integrated as a crosscutting concern across all levels of health programs. Multisectoral collaborations involving communities and schools can achieve regulatory and meaningful reductions in tobacco use.