title: Socio-economic disparities in tobacco consumption in rural India: evidence from a health and demographic surveillance system.
abstract: OBJECTIVE
  India houses over 275 million tobacco users, with 164 million users of only smokeless tobacco, 69 million exclusive smokers, and 42 million users of both smoking and smokeless tobacco. This study aims to examine the socio-economic factors associated with types of tobacco use in a selected rural Indian population.
  
  
  METHODS
  A cross-sectional study was conducted with surveillance data from the Birbhum Population Project (BIRPOP). Total respondents of 29,783 individuals (16,038 men and 13,745 women) aged ≥15 years were surveyed between October 2010 and January 2011. Apart from bivariate analyses, a binary logistic regression was applied to estimate the adjusted odds ratio for socio-economic factors (religion, social group, education, occupation, and wealth quintile) associated with current tobacco use, current smokeless tobacco use, and current bidi use among men and women.
  
  
  RESULTS
  Nearly 22% of men and 26% of women were using smokeless tobacco. While 46% of men were smoking bidi, only 4% of women reported smoking bidi. Overall, men are more likely to use tobacco. Irrespective of gender, with increasing years of education, people are less inclined to use tobacco, and unemployed people are less likely to use tobacco. With increasing income, the odds of smokeless tobacco use and the odds of smoking bidi are higher among women and men, respectively.
  
  
  CONCLUSIONS
  The BIRPOP study indicates that irrespective of gender and income, raising the level of awareness through household-based health education could be an effective intervention to minimise the level of tobacco use.
authors.affiliation: Research Coordinator, Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, IndiaSenior Medical Officer, Chest Clinic, District Tuberculosis Centre, District Hospital of Birbhum, Suri, Birbhum, West Bengal, India.
authors.forename: Anamitra
authors.initials: A
authors.lastname: Barik
authors.affiliation: Senior Research Scientist, Society for Health and Demographic Surveillance, Suri, West Bengal, India rajesh.iips28@gmail.com.
authors.forename: Rajesh Kumar
authors.initials: RK
authors.lastname: Rai
authors.affiliation: Survey Manager, Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, India.
authors.forename: Ashoke
authors.initials: A
authors.lastname: Gorain
authors.affiliation: Data Manager, Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, India.
authors.forename: Saikat
authors.initials: S
authors.lastname: Majumdar
authors.affiliation: Project Director, Society for Health and Demographic Surveillance, Suri, Birbhum, West Bengal, IndiaProfessor & Head, Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education & Research (IPGMER), Kolkata, West Bengal, India.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Chowdhury
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D012959:Socioeconomic Factors; D064424:Tobacco Use; D014029:Tobacco Use Disorder; D055815:Young Adult
keywords: Asia; India; smoking; social determinants of health; tobacco use