Trends in bidi and cigarette smoking in India from 1998 to 2015, by age, gender and education (original) (raw)
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Patterns and related factors of bidi smoking in India
Tobacco Prevention & Cessation
INTRODUCTION Bidis are the most commonly smoked tobacco product in India. Understanding bidi smoking is important to reducing overall tobacco smoking and health-related consequences in India. We analyzed 2009-2010 and 2016-2017 Global Adult Tobacco Survey (GATS) India data to examine bidi smoking and its associated sociodemographic correlates and perceptions of dangers of smoking. METHODS GATS is a nationally representative household survey of adults aged ≥15 years, designed to measure tobacco use and tobacco control indicators. Current bidi smoking was defined as current smoking of one or more bidis during a usual week. We computed bidi smoking prevalence estimates and relative change during 2009-2010 and 2016-2017. Used pooled multilevel logistic regression to identify individual-level determinants of bidi smoking and neighborhood-level and state-level variations.
Attributable deaths from smoking in the last 100 years in India
Tobacco use, and in particular smoking, is the largest cause of preventable death among adults in India, as it is globally. Bidi, an indigenous, leaf-rolled cigarette made from coarse sun-cured tobacco, tied with a coloured string at one end, is the dominant form among all smoked products. More than eight to ten bidis are consumed for every cigarette in India. We present mortality estimates from smoking cigarettes and bidis manufactured over the last 100 years in India. There are currently no estimates of mortality, over a period of time, in India that can be directly attributed to cigarettes/bidis manufactured in the country. The objective of this study is to estimate the number of premature deaths that can be attributable to cigarette and bidi manufactured and consumed over the last 100 years in India. Nearly 4.52 trillion cigarettes and 40.3 trillion bidis have been produced between 1910 and 2010, which are estimated to be responsible for nearly 100 million premature deaths (in which bidis contributed 77 million deaths) in adult men of ≥35 years. Some of these deaths will occur up to the middle of this century. These estimates are derived from the most conservative datasets and yet present alarming mortality estimates. This communication calls for greater emphasis on epidemiological research and a review of existing tobacco control measures in India, which together need to inform measures needed for reducing tobacco use and restricting the proliferation of the tobacco industry.
Smoking trends among women in India: Analysis of nationally representative surveys (1993-2009)
South Asian Journal of Cancer, 2014
The trends of prevalence and use of tobacco was estimated according to gender, literacy and states among respondents aged >15years. Literacy status was categorized into four grades: No formal schooling (illiterate), less than primary education (<5years), primary, but less than secondary (5-9years), secondary and above (≥10years). All the surveys employed multistage stratified sampling methodology with 3-stage sampling in urban and 2-stage sampling in rural areas. The response rates of GATS, NFHS-III and NFHS-II were 92%, 98% and 96% respectively. Global Adult Tobacco Survey (2010) Global Adult Tobacco Survey (2010) was carried out in all 29 states of the country and two Union Territories of Chandigarh and Pondicherry among persons aged 15 and above. A total of 69,296 respondents participated in the survey. National Family Health Survey-III National Family Health Survey-III (2005-2006) interviewed a nationally representative sample of 109,041 households, 124,385 women aged 15-49 and 74,369 men aged 15-54 in all 29 states of India. National Family Health Survey-II National Family Health Survey-II (1998-1999) covered a representative sample of over 91,000 ever-married women age 15-49 years across 26 states of India. Results The survey estimates show that smoking prevalence among males over the last two decades has an overall declining trend with a significant decline (P < 0.001) in smoking prevalence (33.4-24.3%) during the period 2005-2009. However, an overall rising trend of female smoking was observed with a significant (P < 0.001) rise (1.4-2.9%) during the period 2005-2009. The male: female smoking ratio dipped significantly during the period 2005-2009 due to the twin effect of rise in female smoking and decline in male smoking [Table 1]. Evidence in this study suggests that smoking prevalence decreases with increase in per capita GDP irrespective of gender status [Figure 1]. According to GATS (2009-10), the states categorized among the highest per capita GDP states such as Delhi, Goa had low female smoking prevalence whereas other states with high per capita GDP like Maharashtra and Kerala (near) zero prevalence of female smoking. The currently smoking females in low per capita GDP states of Mizoram, Sikkim and Nagaland were
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.
Wellcome Open Research
Background: Data on prevalence of hardcore smoking (HCS) among different socioeconomic status (SES) groups in low- and middle-income countries are limited. We looked at the prevalence and pattern of HCS in India with the following objectives: 1) to analyse the association between SES and HCS, 2) to find trends in HCS in different SES groups and 3) to find state-wide variations in hardcore smoking. Methods: Data of individuals aged ≥25 years from the Global Adult Tobacco Survey (GATS) India 2009-10 (N= 9223) and 2016-17 (N= 7647) were used for this study. If an individual met all the following criteria: (1) current smoker, (2) smokes 10 or more cigarettes/day, (3) smokes first puff within 30 minutes after waking up, (4) no quit attempt in last 12 months, (5) no intention to quit at all or in the next 12 months, (6) lack of knowledge of harmful effect of smoking, s/he was identified as a hardcore smoker. Multiple regression analysis was done to find the factors associated with HCS. Re...
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.
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.
Tobacco consumption patterns and its health implications in India
Health policy, 2005
The main objective of this paper is to analyze the pattern of tobacco consumption and its health implications in India. We use various rounds of National Sample Survey for this purpose. The paper finds that, though there is a reduction in tobacco consumption in the form of bidi and cigarette in India as a whole, this decrease is compensated for by an increase of pan consumption in rural India. It has also been observed that the consumption of tobacco is more among the poor in India and we argue that the consequent higher health care spending arising out of tobacco related diseases leaves them economically worse off. Thus the paper concludes that, apart from the economic gains that tobacco industry is generating, tobacco use also imposes burden, especially on users, in the form of numerous tobacco related diseases and high health care spending. This, coupled with the fact that the investment on health by government is declining over the years, has the potential to trap the poor in a vicious circle of poverty and ill health. Hence government policy needs to be targeted towards an effective control of tobacco use.
Tobacco Use and Cessation among a Nationally Representative Sample of Men in India, 2019–2021
Journal of Smoking Cessation
Tobacco users are exposed to a higher risk of noncommunicable diseases, leading to premature mortality and disability-adjusted life years (DALYs). The future prediction indicates that tobacco-related mortality and morbidity rates will substantially increase in coming years. The study is aimed at assessing the prevalence of tobacco consumption and cessation attempts for different tobacco products among adult men in India. The study utilized information from India’s latest National Family Health Survey-5 (NFHS-5) data which was conducted during 2019-21, including 988,713 adult men aged 15 years and above and 93,144 men aged 15-49. Results suggest that 38 percent of men consume tobacco, including 29% in urban and 43% in rural areas. Among the men aged 35-49 years, the odds were significantly higher for consuming any form of tobacco (AOR: 7.36, CI: 6.72-8.05), smoking cigarettes (AOR: 2.56, CI: 2.23-2.94), and smoking bidi (AOR: 7.12, CI: 4.75-8.82) as compared to those aged 15-19. The ...
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.