Smoking cessation among middle-aged and older adults in India

There are close to 100 million combustible tobacco users in India. This study was conducted to assess the national and state-level estimates for smoking quit ratio and identify the factors associated with quitting smoking among life-time combustible tobacco users aged 45 years and above in India. A cross-sectional analysis of a representative sample of 11,920 lifetime combustible tobacco users aged ≥ 45 years extracted from the Longitudinal Ageing Study in India (LASI) was conducted. Quit ratio was defined as the ratio of individuals who quit smoking to lifetime combustible tobacco users. Descriptive estimates for quit ratios at the national and state levels were computed. Adjusted odds ratios (AOR) using binary logistic regression analysis were computed to identify the factors associated with quitting smoking. The smoking quit ratio at the country level was estimated as 21.1%. Among major states, Kerala (49.0%, 95% CI = 48.9-49.1) had the highest quit ratio. Individuals aged 61 years and above (AOR = 1.72; 95% CI = 1.46-2.03), healthcare visits (AOR = 1.29; 95% CI = 1.09-1.53), diagnosis with non-communicable diseases like cancer, lung disease, heart disease or stroke (AOR = 1.87, 95% CI = 1.52-2.30) had significantly higher odds of successfully quitting smoking. Individuals consuming alcohol at least once a month (AOR = 0.55; 95% CI = 0.42-0.71) had lower odds of quitting smoking compared to their counterparts. The less-than-optimal quit ratios at national and state levels among lifetime combustible tobacco users in India are reflective of the bottlenecks in tobacco cessation support availability, access, and use. A higher quit ratio was observed in states that invested in strengthening tobacco control systems.