Tobacco Use In India Research Articles

Decentralized big data mining: federated learning for clustering youth tobacco use in India

This study examines the smoking patterns of youth across various states and union territories of India using the Global Youth Tobacco Survey (GYTS) dataset. The analysis employs three clustering algorithms K-Means, DBSCAN, and Hierarchical Clustering within a federated learning framework, which ensures that sensitive public health data remains decentralized and private. Federated learning enables collaborative analysis across different regions by sharing only model parameters rather than raw data, thus enhancing privacy. Furthermore, the integration of differential privacy ensures additional protection by adding controlled noise to the model parameters, safeguarding individual-level data from exposure during the learning process. The study highlights the varying performances of the clustering algorithms, revealing valuable insights into regional smoking behaviors and the effectiveness of government anti-tobacco campaigns. These insights offer important guidance for public health authorities, allowing for the design and implementation of more targeted and effective campaigns tailored to the needs of specific regions. By leveraging federated learning and differential privacy, this study demonstrates a privacy-preserving approach to analyzing large-scale public health data, providing a blueprint for future health interventions and tobacco control strategies in India and beyond.

Countering Tobacco Industry Interference: A Policy Brief on Strengthening the WHO FCTC Article 5.3 Adoption in India

Tobacco use in India contributes to over 1.35 million deaths annually, posing a major public health challenge. Tobacco industry interference (TII) is a significant barrier to effective tobacco control, especially in low- and middle-income countries (LMICs), such as India. This interference undermines public health efforts by manipulating policy implementation and enforcement. The adoption of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) Article 5.3 in India has made progress, with 23 states implementing the guidelines. However, enforcement gaps and persistent tobacco industry (TI) tactics continue to weaken tobacco control measures. Nefarious strategies, such as lobbying and misinformation, further complicate the effective execution of these policies. To effectively reduce tobacco use in India, stronger and enforceable policies are needed at both national and state levels. Strengthened legal frameworks, increased public awareness, and robust monitoring systems are critical to protect public health policies from TII. These steps are essential to safeguard public health and enhance the impact of tobacco control initiatives.

Trend and determinants of tobacco use among Indian males over a 22-year period (1998-2021) using nationally representative data.

Tobacco consumption is associated with an increased risk of morbidity and mortality. India is one of the largest consumers of tobacco worldwide. We assessed the trend of tobacco use among Indian males over a period of 20 years using data obtained from four rounds of the National Family Health Survey (NFHS). Data on tobacco usage and relevant socioeconomic variables obtained from NFHS rounds 2 to 5 over the period 1998-2021, was used for analysis. Specifically, data were available for 138,951 males from NFHS-2, 74,369 males from NFHS-3, 112,222 males from NFHS-4, and 101,839 males from NFHS-5. Significance of association between various socio-economic factors and tobacco usage was ascertained using a multicategory logistic regression model. Among all the forms of tobacco, smokeless tobacco was predominantly used by Indian males. The proportion of smokers and those using both smoke and smokeless forms peaked during NFHS-3, followed by a consistent dip; however, the use of smokeless tobacco plateaued from NFHS-4 to NFHS-5. NFHS-5 shows that 19.2% of Indian males smoked, 27.0% used smokeless tobacco, and 6.3% used both. Tobacco use has declined significantly over the last two decades. Tobacco usage is noticeably higher among the elderly, Muslims, and those from the backward classes, while it was considerably lower for individuals belonging to the educated and wealthier segment. There has been a steady decline in tobacco use in India over the past 22 years, specifically in the smoke-form category. However, smokeless tobacco use remains nearly unaffected. The outcome of this study might aid policymakers in devising targeted tobacco control policies and improving existing ones.

Economy-wide impact of a reduction in tobacco use in India

BackgroundPublic policy measures aimed at regulating tobacco use should consider the net gains for the nation, as the tobacco sector contributes to employment and tax revenue while also imposing substantial...

Tobacco control policies and the multidimensional context of tobacco use by gender: The case of Türkiye.

This study aims to determine the indicators of tobacco use in Türkiye within a multidimensional context as socio-demographic, physical, behavioural, and psychological as a response to the tobacco control policies. The Turkish Health Survey data in 2014 and 2019 are employed within a probit model approach and the differences in tobacco are decomposed use by gender in order to reveal the gender differences. The samples in 2014 (total n=19,129; males=8 721, females=10,408) and 2019 (total n=17,084; males=7 784, females=9300) were restricted to 15-year-old and above. The findings indicate that being in the 30-49 age cohort, having lower education, and being married increase the likelihood of tobacco use. Future policies and campaigns should specifically target the single, pre-obese, employed males who consume alcohol. For females, the gender-specific policies should aim to reduce the prevalence of smoking, especially among separated or widows, obese, and out of the labour force. The contribution of mental health indicators on tobacco use has declined over the 5years, which could be a result of the supportive free health services in Türkiye. The findings provide evidence for a significant and increasing gender difference in tobacco use in Türkiye along with reporting that the most significant contributors to gender differences in tobacco use are alcohol consumption and education level. Even though the Ministry of Health and the government have been implementing anti-tobacco policies, legislations, and campaigns for years, the tobacco use prevalence has remained high and even increased in Türkiye.

Text Message-Based Cessation Intervention for People Who Smoked or Used Smokeless Tobacco in India: A Feasibility Randomized Controlled Trial.

Despite the high burden of tobacco use in India, users do not have access to adequate help. This pilot trial aimed to evaluate the feasibility and acceptability of a text messaging intervention for tobacco cessation, generate preliminary estimates of its impact, and fine-tune procedures for a definitive trial. Parallel two-arm single blind individually randomized controlled pilot trial with nested qualitative study. Participants included adult current tobacco users (smoked and smokeless). Eligible and consenting participants were randomized to receive either (1) text messaging intervention (ToQuit) which covered specific content areas such as psychoeducation about consequences of tobacco use and benefits of quitting and tobacco avoidance strategies or (2) information about tobacco cessation helplines such as the helpline number and the languages in which tobacco cessation support was available (control). Feasibility data included screening and consent rates, treatment dropouts, and outcome ascertainment. The primary abstinence outcome was self-reported abstinence from tobacco in the past seven days at 3 months post-randomization. In-depth interviews were conducted with a subsample of participants primarily to collect acceptability data. The primary abstinence analysis used a chi-squared test and logistic regression (complete case), and qualitative data was analyzed using thematic analysis. Ninety-eight participants were randomized into the two trial arms; 77 (79%) completed outcome evaluation. No between-arm differences in abstinence were found though findings favored the intervention (7-day abstinence: ToQuit 23%, control 19%; adjusted odds ratio 1.23, 95% confidence interval 0.38, 3.97). Participants appreciated the language, comprehensibility, and relevance of the messages; and reported overall satisfaction with and positive impact from the intervention on their lives. The findings indicate the acceptability and feasibility of ToQuit and if found effective, it could be a potentially scalable first-line response to tobacco use in low-resource settings. Our pilot randomized control trial provides sufficient findings supporting the acceptability and feasibility of an intervention for tobacco cessation which is suitable for a context which has a shortage of healthcare workers and for individuals who use smoked or smokeless tobacco. This is critical on a background of limited contextually relevant interventions for a problem with a high burden in low- and middle-income countries such as India.

Socioeconomic inequality among smoking and smokeless tobacco uses among males in India: a decomposition analysis

ObjectiveIndia is the third-largest tobacco manufacturer and its use in India is characterised by a high prevalence of smoking and smokeless (sl) tobacco use. This results in 1 million deaths per year in the country. Given the high burden of tobacco use, this study examines the regional variations and socio-economic correlates of tobacco use in India. MethodsNational Family Health Survey- 5 (2019–2020) have been analysed for the purpose of the study. A sample of 101,839 males aged 15–54 years was included in this study. Primary outcomes of tobacco use were categorised into smoking, smokeless and dual use of smoking and smokeless tobacco use. Bivariate analysis and decomposition analysis was done to study the socio-economic inequality. ResultsThe prevalence of tobacco use among males in India is around 41 percent. As indicated by the results of the logistics regression, age is positively related to smoking among males. Males aged 45–54 years are 2.5 (95 % concentration index [CI]:2.30–2.63) times probable to smoke, 1.4 (95% CI: 1.30–1.47) times probable of smokeless tobacco consumption and 2.2 (95% CI: 2.10–2.35) times more prone to using both types of substances compared to the younger age group. Males who are widower use smokeless 1.69 times (95% CI: 1.44–1.99) higher with reference to unmarried males. Males belonging to Scheduled tribes are 1.2 (95% CI: 1.13–1.25) times more likely to smoke, 1.3 (95% CI: 1.24–1.37) times more likely to use smokeless substances and 1.4 (95% CI: 1.33–1.47) times more likely to have dual use of tobacco than other social groups. Manual workers (both skilled are unskilled) are likely to smoke (odds ratio [OR] = 1.1, 95% CI: 1.02–1.11), use smokeless tobacco (OR = 1.3, 95% CI: 1.23–1.34) and have dual use of tobacco (OR = 1.29, 95% CI: 1.24–1.34) more than that of other categories. The decomposition of the concentration index shows a significant contribution from factors like a no education, ST/SC caste and wealth index. Among the states and union territories, the prevalence of tobacco is high in West Bengal, Tripura, Mizoram, Manipur, Meghalaya and Sikkim. ConclusionThis study is useful for informing target-based prevention policies since it helps in highlighting regions, socio-economic and demographic groups especially vulnerable to tobacco addiction. In India, males from poorer and vulnerable socio-economic backgrounds are more likely to use tobacco. State wise, the eastern zone starting from West Bengal to the North-Eastern states have higher tobacco use than the rest of the country. There is an urgent need to frame policies for controlling the use of tobacco especially among high-risk groups.

HOW ECONOMICS CAN CHANGE THE TOBACCO CONSUMPTION IN INDIA?

Tobacco consumption is a serious health concern and a major problem in India due to its devastating impact to the poor section of society. Effective control on tobacco use must be the priority, both as an approach to eradicate poverty and a health concern. Use of tobacco is deeply entrenched as a cultural practice as it is consumed in different forms. This study is aimed to discuss the economic impact on tobacco use in India along with adverse health consequences. In order to fulfil this objective, this study is based on secondary data collected from various sources like recent studies published in peer-reviewed journals, government reports, records, and media sources. Tobacco consumption is constantly rising irrespective of having tobacco control policy. More aggressive and popular anti-tobacco campaigns are required to improve public awareness of harms caused by tobacco and active engagements of health experts and worksites to encourage tobacco cessation. Either consumed smoke less or as smoke, tobacco is toxic to human body. Tobacco kills over 6.4 million people every year globally, and death toll is rising significantly. Tobacco consumption has been associated with different factors like culture, geographical changes, and other factors. Tobacco was once known as a taboo. With the commercialization and advancements of modern world, it has been common among adults and teenagers.

Shifting the gaze on implementation: examining the association between the implementation of tobacco control laws and prevalence of tobacco using data from a nationally representative survey

BackgroundTobacco use and the associated health burden is a cause of concern in India and globally. Despite several tobacco control policies in place, their sub-optimal and variable implementation across Indian states has remained a concern. Studies evaluating the real-world implementation of policies such as Cigarettes and Other Tobacco Products (COTPA) or National Tobacco Control Program (NTCP) in India and its association with reductions in tobacco use are limited. In this paper, we analyse data from a nationally representative survey to examine how policy implementation is associated with the tobacco use prevalence in India.MethodsWe analysed data from the Global Adult Tobacco Survey (GATS 2016–17) India using multivariable logistic regression. The dependent variables were the use of smoked tobacco, smokeless tobacco, and tobacco in any form. The independent variables were proxies of implementation of the COTPA and the NTCP. We followed a step-wise backward elimination technique to reach the best fit models.ResultsPeople exposed to no-smoking signages had lower odds of using tobacco (OR = 0.70, p < 0.001). People exposed to second-hand smoke (OR = 1.51, p < 0.001) and tobacco product advertisements (OR = 1.23, p < 0.001) had greater odds of using tobacco. Exposure to tobacco advertisements was associated with higher odds of using smokeless tobacco (OR = 1.23, p < 0.001), and smoked (OR = 1.33, p < 0.001) forms of tobacco.ConclusionWe find significant association between the implementation of tobacco control laws/programs and tobacco use in India. Our findings highlight the potential that policy implementation holds in reducing population-level tobacco use thus drawing attention towards the implementation phase of policies. The findings have implications on prioritising enforcement of specific tobacco control measures such as smokefree laws, modifying COTPA signages to encompass all tobacco products including against smokeless tobacco use and strengthening indirect advertising restrictions. Future research could focus on developing and validating predictors specific to policy implementation to support policy evaluation efforts.

Prevalence of smokeless tobacco use in India and its association with various occupations: A LASI study.

More than two-thirds of deaths in developing countries are due to non-communicable diseases, and tobacco is a leading risk factor. There are numerous different socio-demographic factors that impact on the use of smokeless tobacco, of which occupation is one. The objectives of this study are to find out the overall prevalence of smokeless tobacco use (ever and current use), the pattern of association with various occupations and related variables (current and past workers), and the role of childhood adversity on initiation and use. This study used data from the Longitudinal Aging Study in India (LASI) wave 1, a nationally representative cross-sectional study collected in 2017-18. Current and previous users of smokeless tobacco are taken into consideration as the target population. For the data analysis, survey-weighted tools have been applied for descriptive statistics and multivariable logistic regression model. The weighted data analysis has been done using R studio with R version 4. From the sample size of 65,561, 38% have used either smoking or smokeless tobacco. Among them, 40% use tobacco in smoke form, 51% use smokeless tobacco, and 9% take both. At the population level, 22.8 and 20.4% are previous and current users of smokeless tobacco, respectively. Type of occupation, type of employer, place of work, kind of business, and workload were found to be significantly associated with smokeless tobacco use. A deaddiction and tobacco quitting policy targeting rural male informal workers should be the focus of the Government.

Gendered Pattern and Predictors of Tobacco use in India: Evidence from the Second Round of Global adult Tobacco Survey.

India has completed the second round of the Global Adult Tobacco Survey (GATS) to monitor adult tobacco use and progress in tobacco control efforts. This study assesses the gendered pattern of tobacco use and its predictors in the second rounds of GATS. Publicly available GATS-2 (2016-2017) data was analyzed which contains self-reported tobacco use information of ≥15 years Indians (n = 74,037). The independent predictors of "smoking only," "smokeless only," and "dual use" among current male and female tobacco users were assessed using the multinomial regression model. The burden of "smoking only," "smokeless only," and "dual-use" of tobacco were 8.9% (8.74-9.15), 16.69% (16.42-16.96), and 3.89% (3.75-4.03), respectively, in the second round with wide regional variation as well as male dominance in use. Region, age, education, caste, and religion were significantly and consistently associated with different types of tobacco use in both genders. Other contextual predictors of tobacco use were residence, marital status, occupation, awareness, and wealth index (WI). Tobacco use predictors and their gendered patterns are contextual. Monitoring the predictors for tobacco use, which may change over time, should be given priority in the national tobacco control program.

National Tobacco Quitline – A Comparative Study of Prevalence of Smoking and Smokeless Tobacco Use in India: A Brief One-year Report

National Tobacco Quitline – A Comparative Study of Prevalence of Smoking and Smokeless Tobacco Use in India: A Brief One-year Report

Tobacco Consumption and Legislations Regarding Tobacco Use in India – Is It Time for A Policy Change?

One of the most consumed and readily available products causing psychological dependence among the population is tobacco and its related products. Though the government of India is undertaking measures to reduce tobacco consumption, factors like easy availability, lack of monitoring of tobacco use among youngsters, low cost and rapid absorption into the central nervous system is prompting people from a young age to the elderly to consume tobacco-related products. Legislative measures to reduce tobacco consumption seldom reach or benefit people as laws differ across States. This increases the prevalence of respiratory diseases like Chronic Obstructive Pulmonary Disease (COPD) and lung cancer. This review article discusses the status of tobacco consumption in India with emphasis on tobacco-related legislation in States and associated health inequities.

Need for accelerating tobacco control in India: findings from the national cancer registry programme.

To describe the epidemiology of cancer in sites associated with tobacco use in India, according to recent findings from the National Cancer Registry Programme. The data on cancers in sites associated with tobacco use has been sourced from 28 population-based and 58 hospital-based cancer registries of the National Cancer Registry Programme in India. The data covering a period of 5 years (2012-2016) was taken up for analysis. The highest age-adjusted incidence rate (AAR) among males was reported in the Aizawl district in Mizoram (197.3 per 100 000). The AAR was the highest (121.1 per 100 000) in the Papumpare district in females. The top five leading sites were cancers of the lung (10.7%), mouth (8.7%), oesophagus (6%), tongue (6%) and stomach (5%) among males and cancer of the cervix (10.3%), lung (4.3%), oesophagus (3.3%), mouth (3.3%) and tongue (2.7%) in females. The highest significant increase in AAR, indicated by the annual percentage change was seen among males in Aurangabad (3.4) and females in Kamrup urban (2.4). Except for lung cancer, most patients with other cancer types among both genders presented to the health facility with a locoregional (spread to nearby lymph nodes) disease spread. It is projected that in 2025, there will be 694367 cases of cancers in the sites associated with tobacco use. Tobacco uses in either form and cancer in sites associated with tobacco use are an important matter of public health concern in India. Cancer registries play a crucial role in identifying populations with high cancer incidence in sites associated with tobacco use, monitoring the trends over time, and evaluating the impact of tobacco control measures.

One-year continuous abstinence rate for smoking cessation via telephonic counselling: The Indian scenario.

Tobacco control methods differ by country, with telephonic counseling being one of them. The effectiveness of telephone counseling in smoking cessation has been discussed on several occasions. India's tobacco problem is more complex than that of any other country in the world. To begin with, tobacco is consumed in a variety of ways, and India is a large multilingual country with remarkable cultural diversity. In India, the National Tobacco Quitline Service (NTQLS) is a government-run program. Its data from May 2016 to May 2021 were analyzed retrospectively in this cross-sectional study to determine the prevalence and pattern of tobacco use in India, as well as the abstinence rate for smoking cessation. A total of 4,611,866 calls were received by the Interactive Voice Response system (IVR). The number of calls increased from 600 to 5400 per day after the toll-free number was printed on all tobacco products. Smokeless tobacco use was discovered to be more prevalent, with males significantly more likely to use both smoking and smokeless tobacco. At one month and one year after quitting, 33.42% and 21.9%, respectively, remained tobacco-free. The study emphasizes the efficacy of behavioral counseling in increasing abstinence rates. The printing of a toll-free number on tobacco products is an effective strategy for expanding the operation of quit lines. Despite the challenges of cultural diversity and complex tobacco use, India's quit line service has been able to provide counseling to callers with prolonged abstinence and quit rates comparable to the various quit lines around the world.

Combination of behavioral therapy and varenicline for smoking cessation: Time to beat nicotine

ABSTRACTIndia is the second largest tobacco consumer and the third largest tobacco producer in the world. The current trends of tobacco use in India includes 1 million deaths per year, and the problem is worsening, and also, tobacco use will cause 13% of deaths in India by 2022. To control this number, it is an alarming situation to work on the main etiology. Smoking cessation programs are considered very useful in helping tobacco users to quit, as it is a very difficult addiction to break and effective approaches are required. So, authors reported a case of 61-year-old male patient who was a chronic smoker and used to smoke 20–25 cigarettes per day. He started noticing the ill effects of tobacco in the body, so he finally decided to seek help from doctor. His habit reduced to half in few days, and finally he completely quitted smoking with the help of behavioral therapy and pharmacotherapy.

Prevalence of smoking in rural and urban areas in India

The use of tobacco overall in India is given with an advanced rate of frequency of smoking. The high burden of tobacco use, the studies have stated the examined the indigenous, socioeconomic, demographic, and, other factors of smoking, smokeless tobacco in India. The main idea is to study the burden of the complaint, socioeconomic status, demographic of the use of smoking in civic and pastoral places of overall India. The studies have analysed it through a cross-sectional bivariate and multivariate analysis, for representation of the sample of individualities from the Global Adult Tobacco Survey in India. The different forms of tobacco use are in three different forms, substantially smoking only, smokeless tobacco use, and admixture of both uses were considered as outgrowth variables of all the studies. Smokeless tobacco use was the major form of tobacco use in India followed by smoking and binary tobacco use. Tobacco use is in advanced among males than in ladies in the pastoral and civic populations of India. The population was lacking knowledge of the health hazards of tobacco and had an advanced frequency of tobacco use in each form.

Tobacco Use among HIV-Positive and HIV-Negative Women and Men in Zambia-Demographic and Health Survey, 2018.

Country-specific estimates of tobacco use among people living with HIV (PLWH) are lacking for much of sub-Saharan Africa. We aim to evaluate the association between the HIV status and tobacco product use status, frequency, and intensity, using nationally representative data from Zambia. We analyzed data from the 2018 Demographic and Health Survey conducted in Zambia among women aged 15–49 years and men aged 15–59 years. We performed logistic regression to assess the associations of HIV status, selected sociodemographic, and other characteristics with indicators of tobacco use (i.e., status, frequency, and intensity). Among women, 14.3% tested positive for HIV and 2.7% reported current smoking or tobacco use; women living with HIV were more likely to report currently smoking or using tobacco than women living without HIV (4.4% vs. 2.4%; aPR: 1.46). Among men, 8.4% tested positive for HIV and 19.5% reported current smoking; men living with HIV were more likely than men living without HIV to report current smoking (27.8% vs. 18.7%; aPR: 1.22). Several sociodemographic characteristics were associated with tobacco use, including age, residence (urban/rural), education level, employment status, and wealth index. The frequency and intensity of smoking among men who currently smoked did not differ by HIV status. Tobacco use was more likely in PLWH than those without HIV in Zambia. Our findings highlight the need to encourage and support tobacco cessation among PLWH, possibly by offering cessation services at existing intersections with health care or integrating cessation support into mHealth and other alternative models of care.

Health Warning Label Compliance for Smokeless Tobacco Products and Bidis in Five Indian States.

The burden of tobacco use In India is very high. To inform users of harm, India has a strong health warning label law that applies to all tobacco products. This study examines the extent of compliance of health warning labels on smokeless tobacco (SLT) and bidi products with the Indian law. In 2017, a systematic protocol was used to collect unique SLT and bidi packages from five Indian states. To assess compliance, we used three indicators: location, label elements, and warning size. Only 1% of the 133 SLT products and none of the 32 bidi packs were compliant with all three compliance indicators. Other compliance-related issues included non-standardized packaging, incomplete health warning labels, poor printing quality, and old warning labels. There is very poor compliance with the health warning label law on bidi and SLT products. India needs to regularly monitor and address implementation to ensure that warning labels are effective.

Socio-demographic profile of smokeless tobacco use in India

Socio-demographic profile of smokeless tobacco use in India