Tobacco Use and Cessation among a Nationally Representative Sample of Men in India, 2019-2021

Tobacco users are exposed to a higher risk of noncommunicable diseases, leading to premature mortality and disability-adjusted life years (DALYs). The future prediction indicates that tobacco-related mortality and morbidity rates will substantially increase in coming years. The study is aimed at assessing the prevalence of tobacco consumption and cessation attempts for different tobacco products among adult men in India. The study utilized information from India's latest National Family Health Survey-5 (NFHS-5) data which was conducted during 2019-21, including 988,713 adult men aged 15 years and above and 93,144 men aged 15-49. Results suggest that 38 percent of men consume tobacco, including 29% in urban and 43% in rural areas. Among the men aged 35-49 years, the odds were significantly higher for consuming any form of tobacco (AOR: 7.36, CI: 6.72-8.05), smoking cigarettes (AOR: 2.56, CI: 2.23-2.94), and smoking bidi (AOR: 7.12, CI: 4.75-8.82) as compared to those aged 15-19. The application of multilevel model indicates that tobacco usages are not evenly distributed. In addition, there is maximum clustering of tobacco usages found around household level factors. Further, 30% of men aged 35-49 years attempted to stop consuming tobacco. Though 27% of men tried to quit tobacco in the last 12 months and 69% of men are exposed to secondhand smoke, 51% of men who received advice for quitting tobacco and visited the hospital in the last 12 months belong to the lowest wealth quintile. These findings prioritize promoting awareness about adverse effects of tobacco use, especially in rural areas, and capacitate them to adopt cessation efforts so that those who want to quit may be successful in their efforts. In addition, the health system's response to the tobacco epidemic in the country should be strengthened by training of service providers to promote cessation efforts through appropriate counselling of all the patients visiting them in the context of tobacco use in any form as key drivers of the increasing burden of noncommunicable diseases (NCDs) in the country.