Mortality risk among tobacco users in a rural population of southern India: Evidence from a cohort study.

ABSTRACT

Background. Tobacco has long been identified as one of the most hazardous risk factors detrimental to health. To plan and implement anti-tobacco activities in any community, it is necessary to understand the risk it poses in that setting. We assessed the risk of mortality associated with tobacco use in a rural community of Kerala. Methods. This cohort study (PROLIFE) was done in Varkkala, a rural development block of Thiruvananthapuram district of Kerala. Adults aged 20 years and above were included. Age-adjusted mortality rates were computed for both users and non-users of tobacco. The risk of mortality was plotted using Kaplan–Meier curves. Cox regression was used to compute the age-adjusted hazard ratio of mortality among tobacco users. Results. More than one-fourth of the study population used tobacco. The age-adjusted mortality rates were higher among tobacco users. The major causes of death among both users and non-users of tobacco were similar. The incidence proportion of death among all causes of death was higher for tobacco users. The hazard of mortality was significantly more among tobacco users, with the age-adjusted hazard ratio being 1.225 (1.140–1.315). Conclusion. The mortality risk due to tobacco use is high irrespective of the cause of death.