Affordable Access

Publisher Website

Trends and determinants of tobacco use initiation in India: analysis of two rounds of the Global Adult Tobacco Survey.

Authors
  • Verma, Madhur1
  • Rana, Kirtan2
  • Bhatt, Garima3
  • Sharma, Nikita4
  • Lal, Pranay5
  • 1 Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India [email protected] [email protected]. , (India)
  • 2 Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India [email protected] [email protected]. , (India)
  • 3 Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India. , (India)
  • 4 Department of Community and Family Medicine, All India Institute of Medical Sciences, Bilaspur, India. , (India)
  • 5 Department of Health, Government of National Capital Territory of Delhi, New Delhi, India. , (India)
Type
Published Article
Journal
BMJ Open
Publisher
BMJ
Publication Date
Sep 22, 2023
Volume
13
Issue
9
Identifiers
DOI: 10.1136/bmjopen-2023-074389
PMID: 37739473
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Early initiation of tobacco use can lead to lifelong addiction and increases tobacco-attributable morbidity and mortality. This study assesses trends in tobacco use initiation and factors associated with tobacco use initiation using disaggregated data from two rounds of the Global Adult Tobacco Survey India (GATS; 2009-2010 (GATS 1) and 2016-2017 (GATS 2)). Secondary analysis of repeated cross-sectional studies. The study involved data from 69 296 individuals and 76 069 households in GATS 1 and 74 037 individuals and 77 170 households in GATS 2, two rounds of a nationally representative survey in India. Mean age of initiation (as recalled by the participants) of smoked and smokeless tobacco (SLT) use (dependent variable) was compared and analysed across different sociodemographic variables (independent factors). We assessed change in mean age of initiation of tobacco usage on a daily basis between GATS 1 and GATS 2, and investigated the factors associated with early tobacco use initiation in the GATS 2 dataset (reported using adjusted ORs (aORs) with 95% CIs). The mean age of initiation of smoked tobacco and SLT in GATS 2 was 20.9±8.5 and 22.3±10.6 years, compared with 18.5±9.7 and 19.7±12.0 years in GATS 1. The mean age of initiation increased with age and among those who were better aware of the adverse effects of tobacco. As per GATS 2, males initiated smoked tobacco and SLT use earlier (20.6±7.4 and 21.7±9.1) than females (23.3±14.2 and 23.2±12.6 years). Younger participants (15-24 years) reported earlier initiation of SLT (15.5±4.2 years) compared with others. Binary logistic regression depicted variables associated with early initiation of tobacco. Awareness about the harms caused by tobacco affected the odds of SLT (aOR 1.4, 95% CI 1.3 to 1.7) and dual usage initiation (1.8, 1.6 to 2.0), but not of initiation of smoked tobacco products (1.1, 0.9 to 1.2). More robust health advocacy campaigns that communicate the harmful effects of tobacco on health could be useful to delay tobacco initiation, along with reducing the ease of access and affordability of tobacco products among vulnerable groups. © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Report this publication

Statistics

Seen <100 times