Social disparities in tobacco use in India: The roles of occupation, education and gender.

Background: Identifying social disparities in patterns of tobacco use with regard to education, occupation, and gender characteristics can provide valuable insights into the tobacco use patterns of the population. Aim: We assessed social disparities in tobacco use, smoking, and smokeless tobacco use by examining occupation-, education-, and gender-specific patterns. Setting: About 69,030 Indian residents ΃15 years in 29 States and 2 Union Territories (UT). Design: Three-stage sampling in urban areas and two-stage sampling in rural areas for selection of households. Materials and Methods: Data has been derived from GATS 2009-2010, wherein the sample was collected through household interviews. Statistical Analysis: Percentages, proportions, adjusted odds ratios (ORs), and 95% confidence interval (CI) were reported. Results: As a person entered adulthood, the prevalence of ever tobacco use increased by 51.5% among men and 28.8% among women. Prevalence was 2.5 times higher in men (mainly smoking) as compared to women (predominantly smokeless form). ORs for tobacco use were higher among illiterate respondents as compared to the college educated (male OR = 4.23, female OR = 8.15). Unemployed, able to work (male OR = 1.50, female OR = 1.23) showed highest risk, while students (male OR = 0.35, female OR = 0.52) showed the least. The combined effect of occupation and education showed synergistic interaction among females and antagonistic interaction among males. Conclusion: The study clearly underscores the individual and joint effects of education and occupation on tobacco use besides discussing variations based on gender. This can have far-reaching policy implications in addressing disparities in tobacco use.

Profile of dual tobacco users in India: An analysis from Global Adult Tobacco Survey, 2009-10.

Introduction: Individuals who use both smoked and smokeless tobacco products (dual tobacco users) form a special group about which little is known. This group is especially relevant to India, where smokeless tobacco use is very common. The aim of this study was to characterise the profile of dual users, study their pattern of initiation to the second product, their attitudes toward quittingas well as their cessation profile. Methods and Materials: The GATS dataset for India was analyzed using SPSS; . Results: In India, dual tobacco users (42.3 million; 5.3% of all adults; 15.4% of all tobacco users) have a profile similar to that of smokers. Some 52.6% of dual users started both practices within 2 years. The most prevalent product combination was bidi-khaini (1.79%) followed by bidi-gutka (1.50%), cigarette-khaini (1.28%), and cigarette-gutka (1.22%). Among daily users, the correlation between the daily frequencies of the use of each product was very high for most product combinations. While 36.7% of dual users were interested in quitting, only 5.0% of dual users could do so. The prevalence of ex-dual users was 0.4%. Conclusion: Dual users constitute a large, high-risk group that requires special attention.