Tobacco Use and Cessation among a Nationally Representative Sample of Men in India, 2019–2021 (original) (raw)
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Environmental Health and Preventive Medicine, 2020
Background: Tobacco consumption causes almost 638,000 premature deaths per year in India. This study sought to examine the prevalence and determinants of tobacco use among men in India. Methods: We analyzed data from the fourth round of the National Family Health Survey in India. These nationally representative cross-sectional sample data were collected from January 20, 2015, to December 4, 2016. A total of 112,122 men aged 15-54 years were included in this study. Primary outcomes were tobacco use categorized into smoking, smokeless, any tobacco, and both smoked and smokeless tobacco use. Complex survey design and sampling weights were applied in both the descriptive analyses and logistic regression models. We present the findings using odds ratios. Results: The prevalence of tobacco use among men in India for the studied period was 45.5% (95% CI 44.9-46.1), smoking was 24.6% (95% CI 24.1-25.1), smokeless tobacco use was 29.1% (95% CI 28.6-29.6), and both smoked and smokeless tobacco use was 8.4% (95% CI 8.1-8.7). The prevalence of tobacco use among men was higher among the elderly, separated/divorced/widowed individuals, those with lower education and wealth status, alcohol consumers, manual workers, and residents of the northeast region. Multivariate analysis showed that age, lower education, occupation, region, alcohol consumption, separated/divorced/widowed status, and economic status were substantially associated with tobacco use among Indian men.
Family Medicine & Primary Care Review, 2019
Background. Tobacco smoking is a global epidemic among adults and increases the risk of different diseases, and premature deaths. Objectives. This study attempts to investigate and estimate the prevalence and risk factors of tobacco smoking among adults in India. Material and methods. This study utilized cross-sectional data from the nationally representative 2017 Global Adult Tobacco Survey. Chi-square analysis was used to show the association between tobacco smoking and risk factors. Binary logistic regression was used to determine the risk factors of tobacco smoking based on p-values and odds ratio along with confidence interval. Results. The overall prevalence of tobacco smoking was 12.84% (Male: 25.01%, Female: 2.63%). The highest prevalence of tobacco smoking was in Meghalaya (35.04%) and the lowest in Goa (3.07%). Genderwise, the highest prevalence of tobacco smoking was 57.27% in Meghalaya for males and 7.27% in Manipur for females. This study found that 16 out of 19 covariates were significantly (p < 0.001) associated with tobacco smoking. Age, region, gender, education, religion, marital status, wealth index, number of living persons, and presence of smoking persons were found to be highly significant (p < 0.001) risk factors. Adults from 46-60 years, north east region, no education, daily wage/casual labourers and self-employed, non-Hindu, married. Poorest, presence of smoking persons, and no knowledge about smoking cause strokes had significantly higher risk of tobacco smoking. Conclusions. Tobacco smoking remains one of the major causes of diseases, deaths and economic losses. This recent realistic evidence will help policy makers to make policy for reducing tobacco smoking in India, as well as different states.
Indian Journal of Community Health, 2017
Tobacco use is the most common cause of non-communicable disease related morbidity and mortality worldwide despite being preventable. Almost fifty percent or more than seven million tobacco users get killed each year and about 13 percent of them are non-smokers being exposed to second hand smoke (1). According to the recent National family health survey (NFHS-4) study for the year 2015-16, there were 38.9% men who use any kind of tobacco in urban while 48% in rural areas of India. On the other hand, 4.4% of women in urban and 8.1% in rural use any kind of tobacco. Prevalence of tobacco use in the ages of 13-15 among boys was 19% and girls 8.3 % according to global youth tobacco survey of 2009. The tobacco dependence was considered as disease by the international classification of diseases (ICD 10). Proportion of tobacco related cancers in comparison to all other cancers were reported to be as high as 25% in men and 18% in women (2).
Changing pattern of tobacco consumption and quitting behavior in Northeast India
Journal of Substance Use, 2021
Objective: This paper aims to understand the recent trends and correlation of tobacco use and factors associated with an attempt to quit smokeless tobacco (SLT) use among adults from Northeast India. Methods: We used data from two rounds of the cross-sectional Global Adult Tobacco Survey. The paper applied proportion test statistics to examine the change in the prevalence of tobacco use between the two periods. Binary logistic regression was applied to determine the associated risks of tobacco use. Results: Prevalence of SLT use among adults increased signi cantly by 3.9% from 2009-10 to 2016-17. In the same period, the prevalence of smoking had declined by 2.4%. Increase in use of SLT use was more prominent among women and illiterate adults, rural and poor households, while a decrease in prevalence of smoking was observed among adults. A signi cant proportion of educated people, students, and homemakers, reported that they had quit smoking; however, the proportion of attempts to quit SLT had increased signi cantly among older adults, rural residents, and those with low education levels. Conclusions: Actions involving the community, youth, women, the less educated and poor adults are necessary to encourage them quit SLT use and smoking in the northeastern states of India.
BMC Public Health, 2013
Background: Nearly 275 million adults (15 years and above) use tobacco in India, which contributes substantially to potentially preventable morbidity and mortality. There is good evidence from developed country settings that use of tobacco cessation services influences intention to quit, with a higher proportion of attempts being successful in fully quitting. There is little evidence about cessation and quitting behaviour in the Indian context. This study assesses the socio-demographic characteristics and cessation services used by adults i) who attempted to quit smoked and smokeless tobacco and ii) who were successful in quitting. Methods: The study was a cross-sectional secondary data analysis of the Global Adult Tobacco Survey, India, 2009-10. There were 25,175 ever tobacco users aged 21 years and above included in the study. Bivariate and multivariate logistic regression analysis was done to determine associations between socio-demographic variables and cessation services utilized with attempts to quit tobacco and successful quitting. Results: Of the ever tobacco users, 10,513 (42%) made an attempt to quit tobacco, and of these 4,395 (42%) were successful. Significant associations were demonstrated between male gender, increasing educational attainment and higher asset quintiles for both those who attempted to quit and those who were successful. Younger age groups had higher odds of quit attempts than all except the oldest age group, but also had the lowest odds of successful quitting. Heath care provider advice was positively associated with attempts to quit, but both advice and use of cessation aids were not associated with successful quitting. Conclusions: This study provides the first national evidence on the relationships between quitting attempts and successful quitting with socio-demographic characteristics, health care provider advice and use of cessation services. The findings of the study have important implications for scaling up tobacco cessation services in India, and indicate a need to reexamine in greater detail the effects of socio-demographic factors, type of tobacco product used and levels of dependency on quitting. Health system factors such as coverage and accessibility of cessation services, type of service, and its duration and follow up also have to be examined in detail to ascertain effects on quitting behavior.
BMC Public Health, 2015
Background: Tobacco burdens in India and Pakistan require continued efforts to quantify tobacco use and its impacts. We examined the prevalence and sociodemographic and health-related correlates of tobacco use in Delhi, Chennai (India), and Karachi (Pakistan). Methods: Analysis of representative surveys of 11,260 participants (selected through multistage cluster random sampling; stratified by gender and age) in 2011 measured socio-demographics, tobacco use history, comorbid health conditions, and salivary cotinine. We used bivariate and multivariate regression analyses to examine factors associated with tobacco use. Results: Overall, 51.8 % were females, and 61.6 % were below the age of 45 years. Lifetime (ever) tobacco use prevalence (standardized for world population) was 45.0 %, 41.3 %, and 42.5 % among males, and 7.6 %, 8.5 %, and 19.7 % among females in Chennai, Delhi, and Karachi, respectively. Past 6 month tobacco use prevalence (standardized for world population) was 38.6 %, 36.1 %, and 39.1 % among males, and 7.3 %, 7.1 %, and 18.6 % among females in Chennai, Delhi, and Karachi, respectively. In multivariable regression analyses, residing in Delhi or Karachi versus Chennai; older age; lower education; earning less income; lower BMI; were each associated with tobacco use in both sexes. In addition, semiskilled occupation versus not working and alcohol use were associated with tobacco use in males, and having newly diagnosed dyslipidemia was associated with lower odds of tobacco use among females. Mean salivary cotinine levels were higher among tobacco users versus nonusers (235.4; CI: 187.0-283.8 vs. 29.7; CI: 4.2, 55.2, respectively). Conclusion: High prevalence of tobacco use in the South Asian region, particularly among men, highlights the urgency to address this serious public health problem. Our analyses suggest targeted prevention and cessation interventions focused on lower socioeconomic groups may be particularly important.
PLoS ONE, 2014
Background: Tobacco 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 Findings: We 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. Middleaged 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. Conclusions: There is an urgent need to curb the use of tobacco among the subgroups 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.
Journal of Health Management, 2019
Tobacco use continues to be of research interest due to the significant amount of tobacco-attributable non-communicable diseases and deaths in India. This study examines the pattern and predictors of smoking, chewing, and any tobacco use among adults of age 15-49 years in India. This study used secondary data from the fourth round of the National Family and Health Survey (NFHS, 2015-2016) which collected information on tobacco use from men and women in the age group 15-49 (n = 803097). Bivariate and multivariate analyses were conducted to understand the socioeconomic and demographic predictors. GIS maps have been used to show interstate variation in smoking, chewing, and any tobacco use by gender. About one out of every ten adults aged 15-49 use any tobacco, predominantly in chewing forms. Women are significantly less likely to smoke (odds ratio [OR]: 0.05, confidence interval [CI]: 0.04-0.05), chew (OR: 0.25, CI: 0.24-0.25), and use any tobacco (OR: 0.14, CI: 0.13-0.14) compared with men. Tobacco usage was found more common among the uneducated and economically weak people. There is considerable interstate heterogeneity in the prevalence and type of tobacco use, and adults in the northeast region are among the most vulnerable population subgroups. Tobacco use continues to be a significant burden due to its magnitude and different forms of use in India. The higher use among males, illiterates, economically weak, socially backward and alcohol users suggest the need for targeted efforts to improve their knowledge and awareness about the harmful effects of tobacco use and stronger enforcement of tobacco control policies.
https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.3\_March2017/IJHSR\_Abstract.09.html, 2017
Background: Smoking cessation plays a crucial role in reducing mortality and morbidity. Hence, knowledge about pattern of smoking in Indian population and factors influencing smoking cessation can help in effectively implementing interventional measures for its reduction. Objective: To assess pattern of smoking/tobacco habits, level of motivation to quit smoking and to understand the interventional measures that can be taken for effectively achieving smoking cessation. Methods: An observational study was conducted in 577 subjects using a pre-validated questionnaire to analyze the pattern, forms and level of tobacco addiction and level of motivation for smoking cessation. Questionnaire administration by personal visits to participants was followed by a brief presentation on hazards of smoking along with motivation for smoking cessation. The data obtained was analyzed using descriptive statistics. Results: Majority of the smokers were males preferring tobacco smoking over smokeless tobacco. Smoking at public places was avoided by them particularly where smoking was banned. Many of them were not aware of the anti-tobacco campaign/advertisements in the last 30 days. However, it was encouraging to see that majority were willing to quit smoking, especially males and they were ready to take medications for the same. But, very few visited to the doctor and were advised to quit smoking. Health and family concerns were the major reasons contributing for smoking cessation. Conclusion: Smoking bans at home, work and public places, anti-tobacco campaigns and motivation from family and healthcare professionals can facilitate smoking cessation.