Tobacco habit in northern India

To study tobacco consumption practices in north-Indian population, a community-based, stratified sampling survey using validated interview schedule was performed in rural/urban areas of Lucknow, Uttar Pradesh. There were 432 tobacco users (385 men, 47 women; 276 urban, 156 rural) taken as subjects. Tobacco use practices ie, chewing/smoking/rubbing/snuffing, frequency, starting age, supply, place/context of use, quid habit, affect, facilitating conditions/barriers, tobacco users' opinion on control measures were all taken into consideration. Single mode of tobacco use was reported by 277 subjects (64.1%) and the rest had a plethora of tobacco practices. Chewing was prevalent in 322(74.5%), smoking in 256(59.3%), rubbing in 32(7.4%) and snuffing in 4 subjects (0.9%). Of the 10 preparations in the questionnaire, the "top 5" preferences ranked as tobacco-betel, gutka, cigarette, bidi and khaini that remained unchanged between sexes, rural/urban people and age groups. Women significantly (p<0.00001) preferred smokeless tobacco and perceived social barrier for smoking. Gutka consumption was significantly higher in youngsters (<25 yeans; p<0.0001). Most subjects (235; 54.3%) used tobacco 7-24 times/day. Majority (259; 60%) users started consuming tobacco before 21 years of age and about a fifth 95(22%) before 15 years. Majority users (232; 53.6%) did not procure tobacco from a fixed shop. The commonest context of tobacco use was with any refreshment (337; 78.0%). Of the 322 tobacco chewers, about half the subjects (178; 52.2%) rotated the quid in their mouth, 313(97.2%) later spat it out, 9(2.1%) swallowed it and 15(4.7%) admitted to sleep with the quid in mouth. Tobacco along with alcohol was consumed by 82(19%) and with opium by 33 subjects (7.6%). Social barrier to tobacco use was perceived by 231 subjects (53.5%), especially by smokers. Majority users (355; 82.2%) did not have negative feelings or embarrassment in using tobacco. Most users (351; 81.4%) said they would welcome legislative control on tobacco use.