Socioeconomic Gradients in Different Types of Tobacco Use in India: Evidence from Global Adult Tobacco Survey 2009-10.
Socioeconomic differences in tobacco use have been reported, but there is a lack of evidence on how they vary according to types of tobacco use. This study explored socioeconomic differences associated with cigarette, bidi, smokeless tobacco (SLT), and dual use (smoking and smokeless tobacco use) in India and tested whether these differences vary by gender and residential area. Secondary analysis of Global Adult Tobacco Survey (GATS) 2009-10 (n = 69,296) was conducted. The primary outcomes were self-reported cigarette, bidi smoking, SLT, and dual use. The main explanatory variables were wealth, education, and occupation. Associations were assessed using multinomial logistic regressions. 69,030 adults participated in the study. Positive association was observed between wealth and prevalence of cigarette smoking while inverse associations were observed for bidi smoking, SLT, and dual use after adjustment for potential confounders. Inverse associations with education were observed for all four types after adjusting for confounders. Significant interactions were observed for gender and area in the association between cigarette, bidi, and smokeless tobacco use with wealth and education. The probability of cigarette smoking was higher for wealthier individuals while the probability of bidi smoking, smokeless tobacco use, and dual use was higher for those with lesser wealth and education.
Department of Health Promotion, Public Health Foundation of India, Gurgaon, Haryana, India ; Australian Research Center for Population Oral Health (ARCPOH), University of Adelaide, Adelaide, SA 5000, Australia.
Ankur
A
Singh
Department of Health Promotion, Public Health Foundation of India, Gurgaon, Haryana, India.
Monika
M
Arora
Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia.
Dallas R
DR
English
Department of Health Promotion, Public Health Foundation of India, Gurgaon, Haryana, India.
Manu R
MR
Mathur
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000706:statistics & numerical data*; D064424:Tobacco Use / Q000453:epidemiology*; D020340:Tobacco Use Cessation / Q000706:statistics & numerical data*; D061485:Tobacco Use Cessation Devices / Q000706:statistics & numerical data*; D055815:Young Adult