Prevalence of tobacco use among young adult males in India: a community-based epidemiological study

Prevalence of tobacco use in India is reaching alarming proportions, despite efforts by both World Health Organization (WHO) and Government of India (GOI) in controlling it. Part of the problem has been lack of available data on tobacco use in various groups. Although Global Youth Tobacco Survey (GYTS) and National Family Health Survey (NFHS) III have focused on adolescents and adults, respectively, data on use among young adults is lacking. Another limitation has been the use of the questionnaire method to determine tobacco use which may not reveal exact prevalence. This study aimed to explore the prevalence of tobacco use among young adult males in Ranchi, as confirmed by serum cotinine levels.

Five-hundred male students were selected through systematic randomized process to represent 5 universities in Ranchi. After informed consent, the students were administered Tobacco and Other Substance Use questionnaire and then subjected to urine Rapid Nicotine Test to improve sensitivity and biologically confirm prevalence. All tobacco users then were administered Fagerstrom's Scale for Severity of Nicotine Dependence.

Biologically confirmed prevalence of tobacco use among male students was 55.6%, revealing high degree of prevalence in this age group. Predominant form of tobacco use was cigarettes (78%) followed by khaini (20%) and gutkha (2%), showing that most young adults use cigarettes possibly due to the 'cool image' associated with it. Seventy-seven percent of all tobacco users want to quit, thereby giving a strong opportunity to carry out cessation services in this group. There was higher mean Fagerstrom's Scale for Severity of Nicotine Dependence (FTND) score in smokers (6.7 +/- 2.2) compared to chewers (4.6 +/- 2.5), revealing higher severity of dependence among smokers than chewers.