Socio-demographic correlates of tobacco use in Gujarat, India

Background: Disparities in tobacco prevalence and disease disproportionately affect the low-income and male population in India. The purpose of this study was to examine occupation-, education-, and gender-specific patterns of tobacco use as well as knowledge of the hazards of its use among 9,634 Asian Indians (51.2% males and 48.8% females) in Gujarat, India. Methodology: Community- based cross sectional study was conducted in 26 districts of Gujarat in years 2010-2011 using face-to-face interviews by trained community health workers (SEVAKS). Results: Mean age was 40.2±15.8 years. Differential patterns of tobacco use were noted across gender, age and educational levels- 19% of respondents used tobacco in various forms. Prevalence of smoking was 12.8% and significantly higher among males (38.3% vs 1.8% females), older individuals (≥35 years), and those < high school education. More than 2/3rd of respondents were knowledgeable that tobacco use causes lung, oral and other forms of cancer. Despite the knowledge of adverse effects, 73.5% smoked and 87% used tobacco. Odds ratios (ORs) for overall smoking and tobacco use among males, after controlling for education level, age, and occupation, was 7.7 and 4.0 times higher than females. Adjusted ORs for tobacco use according to education level showed a strong gradient; risks were higher among illiterates and participants with less than high school education (OR=1.81) than college graduates. Tobacco use was also significant according to occupation; unskilled male workers, employed male individuals and homemakers were more likely to use tobacco. Conclusions: There is a need for community-focused anti- tobacco campaigns.