Abstract
BackgroundTobacco use in India is characterized by a high prevalence of smoking and smokeless tobacco use, with dual use also contributing a noticeable proportion. In the context of such a high burden of tobacco use, this study examines the regional variations, and socioeconomic, demographic and other correlates of smoking, smokeless tobacco and dual use of tobacco in India.Methods and FindingsWe analyzed a cross sectional, nationally representative sample of individuals from the Global Adult Tobacco Survey in India (2009–10), which covered 69,296 individuals aged 15 years and above. The current tobacco use in three forms, namely, smoking only, smokeless tobacco use only, and both smoking and smokeless tobacco use were considered as outcomes in this study. Descriptive statistics, cross tabulations and multinomial logistic regression analysis were adopted as analytical tools. Smokeless tobacco use was the major form of tobacco use in India followed by smoking and dual tobacco use. Tobacco use was higher among males, the less educated, the poor, and the rural population in India. Respondents lacking knowledge of health hazards of tobacco had higher prevalence of tobacco use in each form. The prevalence of different forms of tobacco use varies significantly by states. The prevalence of tobacco use increases concomitantly with age among females. Middle-aged adult males had higher prevalence of tobacco use. Age, education and region were found to be significant determinants of all forms of tobacco use. Adults from the poor household had significantly higher risk of consuming smokeless tobacco. Lack of awareness about the selected hazards of tobacco significantly affects tobacco use.ConclusionsThere is an urgent need to curb the use of tobacco among the sub-groups of population with higher prevalence. Tobacco control policies in India should adopt a targeted, population-based approach to control and reduce tobacco consumption in the country.
Highlights
Tobacco is used in India in many forms
Smokeless tobacco use consists of chewing pan, chewing gutkha or pan masala, and mishri
Prevalence of smokeless tobacco use is highest in India followed by smoking and dual use of tobacco both among males and females
Summary
Tobacco is used in India in many forms. Smoking of cigarettes and beedis (tobacco wrapped in dried leaves of special trees) is one form of tobacco use. India is one of the fewer countries in the world where prevalence of smoking and smokeless tobacco use are high and is characterised by dual use of tobacco (use of both smoking and smokeless tobacco products) contributes to a noticeable proportion. High prevalence of tobacco use in any form is reported among school going adolescents aged 13–15 years [2]. This high burden of tobacco use is associated with a high mortality burden. Tobacco use in India is characterized by a high prevalence of smoking and smokeless tobacco use, with dual use contributing a noticeable proportion. Tobacco control policies in India should adopt a targeted, population-based approach to control and reduce tobacco consumption in the country
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