Odds Of Smokeless Tobacco Use Research Articles

A nationwide mobile phone survey for tobacco use in Tanzania: Sample quality and representativeness compared to a household survey

We investigated the feasibility of an interactive voice response (IVR) survey in Tanzania and compared its prevalence estimates for tobacco use to the estimates of the 'Global Adult Tobacco Survey (GATS) 2018′. IVR participants were enrolled by random digit dialing. Quota sampling was employed to achieve the required sample sizes of age-sex strata: sex (male/female) and age (18–29-, 30–44-, 45–59-, and ≥60-year-olds). GATS was a nationally representative survey and used a multistage stratified cluster sampling design. The IVR sample’s weights were generated using the inverse proportional weighting (IPW) method with a logit model and the standard age-sex distribution of Tanzania. The IVR and GATS had 2362 and 4555 participants, respectively. Compared to GATS, the unweighted IVR sample had a higher proportion of males (58.7 % vs. 43.2 %), educated people (secondary/above education: 43.3 % vs. 21.1 %), and urban residents (56.5 % vs. 40 %). The weighted prevalence (95 % confidence interval (CI)) of current smoking was 4.99 % (4.11–6.04), 5.22 % (4.36–6.24), and 7.36 % (6.51–8.31) among IVR (IPW), IVR (age-sex standard), and GATS samples, respectively; the weighted prevalence (95 % CI) of smokeless tobacco use was similar: 3.54 % (2.73–4.57), 3.58 % (2.80–4.56), and 2.43 % (1.98–2.98), respectively. Most differences in point estimates for tobacco indicators were small (<2%). Overall, the odds of tobacco smoking indicators were lower in IVR than in GATS; however, the odds of smokeless tobacco use were reversed. Although we found under-/over-estimation of the prevalence of tobacco use in IVR than GATS, the estimates were close. Further research is required to increase the representativeness of IVR.

Gender differences in risk factors for smokeless tobacco use: Insights from the latest nationally representative cross-sectional demographic and health survey (2019–2021) and their potential implications for smokeless tobacco control in the WHO South-East Asia region

Introduction: The global prevalence of Smokeless Tobacco (SLT) use is estimated to be 4.72%, concentrated in South East Asia. Despite declining smoking rates, SLT usage remains high, resulting in 2.5 million DALYs and 90,791 deaths in 2017 due to cancers and heart diseases, with India contributing 70% of DALYs. This study examines risk factors for SLT use in Indian males and females aged 15–49 using 2019–2021 demographic and health survey data, also exploring gender differences. Methods: The study analyzed a substantial sample of 724,115 females and 93,267 males utilizing data from a nationally representative cross-sectional demographic and health survey conducted between 2019 and 2021. Gender-specific multivariable logistic regression analyses were performed to identify risk factors influencing SLT use. Results: The findings reveal gender-specific variations in SLT use risk factors. Among males, older age groups (35–49) were less likely to use SLT compared to those aged 30–34. In contrast, among females, SLT use increased with age, with the highest rates in the 40–44 and 45–49 age groups. Marital status played a significant role, with widowed, divorced, and separated females having higher odds of SLT use compared to currently married females. Tribe ethnicity was associated with increased odds of SLT use in females but not in males. Christian females had higher odds of SLT use than Hindu females, while Christian males had lower odds compared to Hindu males. Conclusion: These findings provide valuable insights for policymakers, healthcare professionals, and public health advocates in developing targeted interventions to combat SLT use in South-East Asia. By addressing gender-specific risk factors and tailoring strategies to different populations, progress can be made in reducing the burden of SLT use and improving public health outcomes in the region.

Prevalence and correlates of tobacco use in Botswana: evidence from the 2014 Botswana STEPwise survey

BackgroundTobacco use is one of the notable risk factors for non-communicable diseases globally. The objective of this study was to assess the prevalence of tobacco use and identify its correlates in the general population of Botswana aged 15 to 69 years.MethodsThis study used a nationally representative WHO STEPwise Approach to Non-Communicable Disease Risk Factor Surveillance (STEPS) risk factors conducted in 2014 to explore the prevalence of tobacco use and its correlates in Botswana. Using IBM SPSS version 27, data on 4062 people aged 15 to 69 years who had been selected using multistage cluster sampling and had successfully completed the individual questionnaire were analysed. The prevalence of current tobacco smoking and smokeless tobacco use was determined using descriptive statistics while multivariable logistic regression was employed to assess correlates of current tobacco smoking and smokeless tobacco use. All comparisons were statistically significant at 5% significance level.ResultsFrom a total sample of 4062 participants the prevalence of current tobacco smoking was estimated to be 12.9% while smokeless tobacco use was 3.2%. Adjusted results indicate that the odds of current tobacco smoking were eight times (AOR = 8.57, C.I = 6.28-11.7) higher among males compared to their female counterparts; six(AOR = 6.52, C.I 3.64-11.6) and three (AOR = 3.27, C.I. =2.07-5.15) times higher among respondents with no education and primary level education respectively, compared to their counterparts with tertiary or higher education; while for alcohol users the odds of current tobacco smoking were four times (AOR = 4.28, C.I = 2.93-6.24) higher than among non-alcohol users. The odds of smokeless tobacco use were significantly higher among women compared to men (AOR = 7.34, C.I = 4.01-13.4); individuals aged 50-59 (AOR = 1.15, C.I = 1.06-3.37) and 60-69 years (AOR = 1.23, C.I. =1.08-3.63) compared to 15-29 years; individuals with no education (AOR = 2.07, C.I = 1.03-4.02) and primary education (AOR = 1.05, C.I = 1.01-2.23) compared to individuals with tertiary education. However, the odds of smokeless tobacco use were significantly lower among individuals who consume alcohol (AOR = 0.48, C.I. = 0.29-0.80) compared to non-alcohol consumers.ConclusionFindings of this study indicate the need to strengthen existing national policies to reduce harmful use of tobacco among men, women, older adults, no or primary education level individuals and alcohol users.

Social desirability and under-reporting of smokeless tobacco use among reproductive age women: Evidence from National Family Health Survey

IntroductionThis study hypothesises that the presence of a third person during the interaction between the survey investigator and the woman respondent leads to underreporting of smokeless tobacco (SLT) use by Indian women, including pregnant and breastfeeding women. MethodsCross-sectional data from the National Family Health Survey conducted in 2015–16 was analysed for SLT use among women aged 15–49. Multivariate logistic regression examined the odds of SLT use reporting by women respondents in the presence of their husbands and other male or female adults. ResultsSLT use reporting by women significantly varied by the presence of someone during the interview. The analysis shows that the odds of reporting SLT use among women who were neither pregnant nor lactating was 20.6% lower when they were interviewed in the presence of their husbands than when they were interviewed alone. Similarly, compared to those interviewed alone, the odds of women reporting SLT use was 16.5% lower among pregnant and breastfeeding women interviewed in the presence of any adult female. The odds of women under-reporting SLT use were higher in Central and Western India. ConclusionsThis study argues that the current survey estimates misconstrue the authentic prevalence of tobacco use among women in India, including pregnant and lactating women. Due to social desirability or the presence of a third person during the survey interview, those respondents who do not report their tobacco use status are also more likely to forego essential support for successful tobacco cessation. Survey methodology must be strengthened to avert the presence of a third person during the interview to ensure better reporting and population health estimates.

Predictors of smokeless tobacco use among the adult population of north-east India during 2009-2017: A decomposition analysis.

Contrary to overall declining trend in smokeless tobacco (SLT) use in India, an increase is observed in north-east (NE) India. This study examined the predictors of daily SLT use by gender and assessed the demographic and socio-economic characteristics that contribute to gender differences in SLT use in NE India. Data collected from 15,259 and 13,574 adults in the two rounds of Global Tobacco Adult Survey 1 and 2 for NE India during 2009-2010 and 2016-2017 were analyzed. Relative change, multivariable binary logistic regression and Blinder-Oaxaca decomposition analysis were used for analysis. The findings suggest that among women in NE India, the daily SLT use significantly increased by 58 per cent between 2009-2010 to 2016-2017. Women residing in Nagaland, Manipur, Mizoram and Tripura were 3.5 and 2.5 times, respectively more likely to be daily SLT users compared to those in Assam. While age, education and wealth were the significant predictors of SLT use in both women and men, increased odds of SLT use were observed with women's type of occupation and the State of residence. The majority of the gender differences in daily SLT use was explained by differences in work status (44%), age (26%), education (14%) and wealth status (9%) between men and women. Increasing prevalence of SLT use amongst women in the NE States necessitates integration of gender-specific messages on harmful effects of SLT in the ongoing tobacco control programmes and development of culturally appropriate community-based interventions for cessation of SLT use.

Slum and non-slum differences in tobacco and alcohol use among the adult population: a sex-stratified study from eight megacities of India

ABSTRACT Background Evidence on the prevalence and determinants of smoking and smokeless tobacco (SLT), and alcohol consumption between slums and non-slums are quite limited. Methods Using sub-samples from the National Family Health Survey (2015–16), prevalence and determinants of tobacco and alcohol use were estimated in eight Indian megacities (Chennai, Delhi, Hyderabad, Indore, Kolkata, Meerut, Mumbai, and Nagpur) by residence and sex using binary logistic regression analyses. Inter-and intra-city differences in both forms of tobacco and alcohol by residence were assessed using interaction effect analysis. Results Strong intra-urban disparity in tobacco and alcohol use was observed. Both forms of tobacco use were higher among men and women residing in slum areas. Despite alcohol use being higher among men from non-slum areas (33.1%) compared to those from slum areas (27.7%), the likelihood of alcohol use was higher among men residing in slums (OR = 1.37;95%CI:1.06–1.77). Higher odds of SLT use were observed among men and women from slums than in non-slum areas. Both forms of tobacco use were higher in slums from North, East, and West Indian cities, whereas alcohol use was higher among males from East and South Indian cities. Conclusions Continuous monitoring of tobacco and alcohol use in slums is warranted to achieve Sustainable Development Goals.

Disparities in smokeless tobacco use in Bangladesh, India, and Pakistan: Findings from the Global Adult Tobacco Survey, 2014-2017.

Smokeless tobacco (SLT) use is associated with multiple adverse health effects. It is prominent in Bangladesh, India, and Pakistan, but disparities in use within and across these countries are not well documented or understood. This study assessed the prevalence, patterns, and correlates of SLT use in these three countries. Data came from the Global Adult Tobacco Survey, a household survey of adults aged ≥15 years. Data were collected in 2014 (Pakistan), 2017 (Bangladesh), and India (2016-2017). Current SLT use (nasal or oral use) was defined as reported SLT use daily or less than daily at the time of the survey. Prevalence of both overall and specific SLT types were assessed. Multivariate logistic regression was used to assess correlates of SLT use. Overall, SLT use among adults ≥15 years of age was 20.6% in Bangladesh, 21.4% in India, and 7.7% in Pakistan, corresponding to 22.0 million SLT users in Bangladesh, 199.4 million in India, and 9.6 million in Pakistan. Among current tobacco users overall, the percentage of those who used SLT was 58.4% (CI: 56.0-60.7) in Bangladesh, 74.7% (CI: 73.4-76.0) in India, and 40.3% (CI: 36.2-44.5) in Pakistan. The most commonly used oral SLT product was Zarda (14.5%) in Bangladesh, Khaini (11.2%) in India, and Naswar (5.1%) in Pakistan. Females had greater odds of SLT use than males in Bangladesh, but lower odds of SLT use than males in India and Pakistan. In all three countries, the odds of SLT use was higher among those 25 years and older, lower education, lower wealth index, and greater exposure to SLT marketing. An estimated 231 million adults aged 15 years or older currently use SLT in Bangladesh, India, and Pakistan, comprising 40.3%-74.7% of overall tobacco product use in these countries. Moreover, marked variations in SLT use exist by population groups. Furthermore, exposure to pro-SLT marketing was found to be associated with higher SLT use compared to non-exposed. It is important that tobacco control strategies address all forms of tobacco product use, including SLT.

Disparities in adult cigarette smoking and smokeless tobacco use by sexual identity

BackgroundWhile there have been reductions in rates of tobacco use in the general population in recent years, rates remain high among sexual minority populations (SMP). Prior studies often group SMP as one category due to limited data. This study examined the association between sexual identity status and tobacco use (cigarette and smokeless tobacco use) among U.S. adults. MethodsData from the 2014–2017 Behavioral Risk Factor Surveillance System were analyzed to examine the association between sexual identity (lesbian or gay, bisexual, other, not sure, and heterosexual or straight) and tobacco use. A propensity score analysis was conducted to address potential imbalance among group characteristics. ResultsLesbian/gay and bisexual groups had significantly higher odds of being an every day smoker (OR = 1.83, 95 % Confidence Interval (CI) 1.59–2.10; OR = 1.36, 95 % CI 1.19–1.55, respectively) and current smoker (every day or some days) (OR = 1.71, 95 % CI 1.52–1.93; OR = 1.44, 95 % CI 1.29–1.62, respectively) compared to straight adults. In terms of smokeless tobacco products, lesbian and gay adults had lower odds of every day and current use. However, significant differences were found in the separate analysis conducted for males and females. While gay and bisexual males had lower odds of smokeless tobacco use, lesbians had significantly higher odds when compared to the straight population. Bisexual females were also more likely to be current users of smokeless tobacco. ConclusionsSignificant heterogeneity in tobacco use was found among sexual minority subgroups. Findings demonstrate the importance of subgroup analysis of SMP. These results have implications for prevention and cessation targeting.

Cigarette, smokeless tobacco, and alcohol use among transgender adults in the United States

BackgroundResearch suggests that sexual minority adults face disparate risks for poor health outcomes. However, prior research on transgender populations has been limited by small and nonprobability samples and has potentially masked important differences between transgender subgroups. We examined disparities in cigarette, smokeless tobacco, and alcohol consumption by transgender and cisgender adults. Methods2014–2017 Behavioral Risk Factor Surveillance System data were used. Multivariable logistic regressions examined differences in cigarette, smokeless tobacco, and alcohol use between cisgender adults and transgender sub-identities: male to female (MTF), female to male (FTM), and gender nonconforming. ResultsCigarette and smokeless tobacco use were higher among transgender adults. The gender nonconforming subgroup reported more binge and heavy drinking. In a multivariable logistic analysis, higher odds of smokeless tobacco use were found for all transgender sub-identities compared to cisgender females. The gender nonconforming group had higher odds of heavy drinking (AOR = 2.09, 95% CI 1.14–3.82) and binge drinking (AOR = 1.94, 95% CI 1.25–3.02) compared to cisgender females. The MTF subcategory was more likely to binge drink (AOR = 1.88, 95% CI 1.44–2.46) compared to cisgender females. The FTM subcategory had lower odds of binge drinking (AOR = 0.49, 95% CI 0.33-0.73) compared to cisgender males. ConclusionsSignificant heterogeneity in smokeless tobacco and alcohol use were found among transgender subgroups, particularly when compared to cisgender females. Our findings demonstrate that it is important to consider sub-identities in both the transgender population and in the reference cisgender population.

Educational and Wealth Inequalities in Smokeless Tobacco Use: An Analysis of Rural-Urban Areas of Bangladesh and India.

This study aims to investigate the educational and wealth inequalities in smokeless tobacco (SLT) use in rural and urban areas of Bangladesh and India, the 2 largest global SLT users. Using the Global Adult Tobacco Survey, both absolute and relative measures of inequality were estimated. The analysis reveals that the educational inequalities in SLT use were higher in urban areas of India and in rural areas of Bangladesh, whereas the wealth inequalities in SLT use were higher in urban areas of both the countries. Moreover, the logit model showed that the odds of SLT use declined with an increase in the level of education and wealth in rural and urban areas of India. However, no consistent pattern was observed in rural and urban areas of Bangladesh. The findings clearly delineate the subgroups which require immediate attention for SLT cessation interventions in these 2 countries.

Deployment and Smokeless Tobacco Use Among Active Duty Service Members in the U.S. Military.

The prevalence of smokeless tobacco use among U.S. active duty service members has been much higher than in the U.S. general population. The association between deployment and smokeless tobacco use has not been well studied. We investigated the association between deployment and smokeless tobacco use among U.S. active duty service members. We also evaluated the modification effects from other factors related to smokeless tobacco use on the deployment-smokeless tobacco use association. Eligible active duty service members stationed at two military installations (Fort Bragg, NC, USA and Lackland Air Force Base, TX, USA) were recruited from July 2015 to May 2016. Each participant completed a self-administered questionnaire. Multivariable logistic regression was used to assess the association between deployment and smokeless tobacco use and estimated odds ratio (OR) and 95% confidence interval (CI). Stratified analysis was performed to evaluate modification effects from other commonly known factors related to smokeless tobacco use in military, specifically, cigarette smoking status, use among family members (family history of use), perception of harm, and use among military peers. Out of 2,465 study participants who completed the questionnaire, 548 were smokeless tobacco users. Service members who had been deployed to a combat zone had 1.39 fold (95% CI = 1.03-1.87) increased odds of using smokeless tobacco than those who never deployed to a combat zone. The odds of smokeless tobacco use among those who had been deployed once, twice, three times and four or more times to a combat zone were 1.27 (95% CI = 0.91-1.78), 1.30 (95% CI = 0.85-1.99), 2.49 (95% CI = 1.45-4.28), and 2.88 (95% CI = 1.71-4.86), respectively, with a significant dose-response trend (p for trend <0.0001). Further, subjects who served in combat units during deployment exhibited more than two-fold increased odds of use as compared with those who had never been deployed (OR = 2.03, 95% CI = 1.41-2.93). In stratified analysis, the association between deployment and smokeless tobacco use was only present among subjects who never smoked cigarettes, those without family history of smokeless tobacco use, and those who had low perception of harm of use. Military deployment was associated with smokeless tobacco use among active service members. However, the influence of military deployment on smokeless tobacco use was not equally strong on all service members. Subjects who never smoked cigarettes, who had no family history of use and who had low perception of harm were the most susceptible subgroups to deployment-related smokeless tobacco use. This study has implications to identify high-risk subgroups to reduce smokeless tobacco use in the U.S. military.

Gender-based tobacco policies in Bangladesh and India: A prerequisite to counter the smokeless tobacco epidemic

ABSTRACTThis study examined gender differences in patterns of smokeless tobacco (SLT) use among various socioeconomic and demographic segments in Bangladesh and India, which are home to 80 percent of global SLT users and share similar sociocultural milieus. The objective was to provide evidence of whether gender-focused interventions and policies might be helpful for SLT cessation programs. Data from the Global Adult Tobacco Survey were used for the analysis. In Bangladesh, data were collected between July and August 2009, and 9,629 individuals were successfully interviewed. In India, data were collected from June 2009 to January 2010, and 69,296 individuals were interviewed. Tests of proportions revealed that the prevalence of SLT use was highest among women in Bangladesh (27.9 percent) and among men (32.9 percent) in India. Logistic regression models revealed that the odds of SLT use was lower among Bangladeshi females in the highest age category. However, in India, a similar observation was made only for females with rural residences. In addition, the odds of SLT use was less among those with a higher level of education and wealth, irrespective of the sex or country. The present findings suggest a need for gender-specific policies and interventions for SLT control.

Socio-economic disparities in tobacco consumption in rural India: evidence from a health and demographic surveillance system.

India houses over 275 million tobacco users, with 164 million users of only smokeless tobacco, 69 million exclusive smokers, and 42 million users of both smoking and smokeless tobacco. This study aims to examine the socio-economic factors associated with types of tobacco use in a selected rural Indian population. A cross-sectional study was conducted with surveillance data from the Birbhum Population Project (BIRPOP). Total respondents of 29,783 individuals (16,038 men and 13,745 women) aged ≥15 years were surveyed between October 2010 and January 2011. Apart from bivariate analyses, a binary logistic regression was applied to estimate the adjusted odds ratio for socio-economic factors (religion, social group, education, occupation, and wealth quintile) associated with current tobacco use, current smokeless tobacco use, and current bidi use among men and women. Nearly 22% of men and 26% of women were using smokeless tobacco. While 46% of men were smoking bidi, only 4% of women reported smoking bidi. Overall, men are more likely to use tobacco. Irrespective of gender, with increasing years of education, people are less inclined to use tobacco, and unemployed people are less likely to use tobacco. With increasing income, the odds of smokeless tobacco use and the odds of smoking bidi are higher among women and men, respectively. The BIRPOP study indicates that irrespective of gender and income, raising the level of awareness through household-based health education could be an effective intervention to minimise the level of tobacco use.

Do Socioeconomic Risk Factors for Cigarette Smoking Extend to Smokeless Tobacco Use?

Individuals with lower socioeconomic status (SES) are at increased risk for cigarette smoking. Less research has been conducted characterizing the relationship between SES and risk of using of other tobacco products. The present study examined SES as a risk factor for smokeless tobacco (ST) use in a US nationally representative sample, utilizing data from the 2012 National Survey on Drug Use and Health. Odds were generated for current cigarette smoking and ST use among adults (≥18 years) based on SES markers (educational attainment, income, blue-collar employment, and unemployment) after controlling for the influence of demographics and other substance dependence. Odds of current cigarette smoking increased as a graded, inverse function of educational attainment as well as lower income and being unemployed. Odds of current ST use also increased as a function of lower educational attainment, although not in the linear manner seen with cigarette smoking. Odds of ST use but not cigarette smoking also increased with blue-collar employment. In contrast to patterns seen with cigarette smoking, ST use did not change in relation to income or unemployment. Markers of SES are significantly associated with odds of cigarette smoking and ST use, but which indicators are predictive and the shape of their relationship to use differs across the two tobacco products.

Predictors and patterns of cigarette and smokeless tobacco use among adolescents in 32 countries, 2007-2011.

This study compared data from 32 countries to assess predictors and patterns of cigarette and smokeless tobacco (SLT) use among students aged 13-15 years old. Data from the 2007-2008 Global Youth Tobacco Surveys were analyzed for students aged 13-15 years in 31 countries located in all six World Health Organization regions. In addition, the 2011 National Youth Tobacco Survey was analyzed for U.S. students aged 13-15 years. Country-specific prevalence of current smoking, current SLT use, and concurrent use patterns were assessed. The national prevalence of current cigarette smoking among students aged 13-15 years ranged from 1.8% (Rwanda) to 32.9% (Latvia), whereas current SLT use ranged from 1.1% (Montenegro) to 14.4% (Lesotho). In the U.S. and most European countries surveyed, current smoking prevalence was significantly higher than SLT prevalence, in contrast to patterns observed in low- and middle-income countries. Also, in most of the surveyed countries outside of Europe and the United States, SLT use among girls was as common as their use of cigarettes, and not significantly different from use by boys. When compared with U.S. adolescents, the odds of SLT use were highest among African adolescents (adjusted odds ratio = 3.98; 95% CI: 2.19-7.24) followed by those in the Southeast Asian region (adjusted odds ratio = 2.76; 95% CI: 1.38-5.53). Region-specific patterns of tobacco use were noticed. Furthermore, it is alarming that in several low- and middle-income countries, the prevalence of SLT use among females did not differ from that among males, suggesting the possibility of a future shared burden of disease between both males and females.

Smokeless Tobacco Use and Its Relation to Panic Disorder, Major Depression, and Posttraumatic Stress Disorder in American Indians

Rates of nicotine use are high in American Indians. Anxiety and depression tend to be associated with cigarette use, but the association of anxiety and depression with smokeless tobacco (ST) is less clear. We asked if panic disorder, major depression, and posttraumatic stress disorder (PTSD) are related to lifetime ST use in 2 American Indian tribes. Logistic regression analyses examined the association between lifetime panic disorder, major depression, and PTSD and the odds of lifetime ST use status after controlling for sociodemographic characteristics, smoking status, and alcohol use disorders in 1,506 Northern Plains and 1,268 Southwest tribal members. Odds of lifetime ST use was 1.6 times higher in Northern Plains tribal members with a lifetime history of PTSD after controlling for sociodemographic variables and smoking (95% CI: 1.1, 2.3; p = .01). This association remained significant after further adjustment for panic disorder and major depression (odds ratio [OR] = 1.5; 95% CI: 1.0, 2.2; p = .04) but was diminished after accounting for alcohol use (OR = 1.3; 95% CI: 0.9, 1.9; p = .23). In the Southwest, lifetime psychiatric disorders were not associated with lifetime ST use status. Increasing psychiatric comorbidity was significantly linked to increased odds of ST use in both tribes. This study is the first to examine psychiatric conditions and lifetime ST use in a large, geographically diverse American Indian community sample. Although approximately 30% of tribal members were lifetime users of ST, the association with lifetime psychiatric disorders was not as strong as those observed with cigarette smoking. Understanding shared mechanisms between all forms of tobacco use with anxiety and depressive disorders remains an important area for investigation.

Mass media exposure, social stratification, and tobacco consumption among Nigerian adults

Mass media exposure is a strong determinant of tobacco use yet little is known about this relationship in African countries. We explored socio-demographic and socio-contextual correlates of tobacco consumption and associations between mass media exposure, gender and the use of any and various forms of tobacco among Nigerians. The study included 47,805 adults from the cross-sectional and nationally representative Nigeria demographic and health survey 2008. Weighted binary logistic models predicted any tobacco use whereas weighted multinomial logistic models predicted smoking and smokeless tobacco, all compared with no tobacco use. Approximately 4.2% of Nigerian adults used tobacco--2.7% smoked tobacco whereas 1.5% used smokeless tobacco. Tobacco use was more prevalent among men than women (12% vs. 0.6%; p value <0.0001). Gender modified the associations between tobacco use and radio exposure or TV exposure (p values ranged = 0.02-0.05). Among men, some radio exposure and high radio exposure were associated with increased odds of any tobacco use, compared with no radio exposure. Among men, infrequently reading newspapers/magazines and frequently reading newspapers/magazines were associated with higher odds of smokeless tobacco use, compared with not reading newspapers/magazines. Among women, infrequently reading newspapers/magazines was associated with reduced odds of smokeless tobacco use, compared with not reading newspaper/magazines. The relationships between mass media exposure and tobacco consumption differed by gender and were more pronounced among men. Research on radio programs may help to form policies that can address tobacco use among Nigerian men.