title: Analysis of motivating factors for smokeless tobacco use in two Indian states.
abstract: BACKGROUND
  This study was conducted to gauge how the demographic profile of smokeless tobacco (SLT) users from Gujarat and Andhra Pradesh, India, differs from that of smokers. It also addresses how factors associated with the initiation and continuation of smokeless tobacco vary by age, gender, and education.
  
  
  METHODS
  We analyzed 2011 cross-sectional survey data collected from 4,759 respondents (smokers/SLT users/ non-users) in both states. Chi-square analysis was used to make comparisons between the demographic profiles of smokers and SLT users. Multivariable logistic regression analysis was used to obtain the odds ratios (ORs) for initiation and continuation factors regressed on socio-demographic variables (age, gender, education).
  
  
  RESULTS
  Initiation-women were less likely than men to report "peer pressure", "fashion statement", and "stress/coping" as relevant factors for SLT use (OR: 0.45 CI: 0.30-0.70; OR: 0.42 CI: 0.24-0.74; OR: 2.47, CI: 1.47-4.15). Older age groups had lower odds of choosing "peer pressure" than the 15-24 year olds. Respondents with 11 or more years of education were more likely to report "stress/coping" than those with no education (OR: 2.82, CI: 1.06-7.48). Continuation-women were less likely than men to choose "relaxation", and "distance from family" as important continuation factors (OR: 0.50, CI:0.32-0.80; OR: 0.20, CI: 0.06-0.65). All age groups were less likely to choose "stimulation" as a factor than the youngest group.
  
  
  CONCLUSIONS
  Along with confirming and expanding upon previous literature, the findings of this study should encourage further SLT research in women and younger age groups (15-24 and 24-44). They also confirm the need for SLT prevention and cessation interventions in India in other community-based settings, besides schools.
authors.affiliation: Center for Disease Dynamics, Economics and Policy, Washington, USA E-mail : danawala@cddep.org, sabadanawala86@gmail.com.
authors.forename: Saba Ashraf
authors.initials: SA
authors.lastname: Danawala
authors.forename: Monika
authors.initials: M
authors.lastname: Arora
authors.forename: Melissa Harrell
authors.initials: MH
authors.lastname: Stigler
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D003625:Data Collection; D004522:Educational Status; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012737:Sex Factors; D012907:Smoking / Q000523:psychology*; D014029:Tobacco Use Disorder / Q000523:psychology*; D014030:Tobacco, Smokeless; D055815:Young Adult