Prevalence and patterns of smoking in Delhi: cross sectional study

Abstract Objective : To determine the prevalence and predictors of smoking in urban India. Design : Cross sectional. Setting : Delhi, urban India, 1985-6. Subjects : Random sample of 13 558 men and women aged 25-64 years. Main outcome measure : Smoking prevalence; subjects who were currently smoking and who had smoked >/=100 cigarettes or beedis or chuttas in their lifetime were defined as smokers. Results : 45% (95% confidence interval 43.8 to 46.2) of men and 7% (6.4 to 7.6) of women were smokers. Education was the strongest predictor of smoking, and men with no education were 1.8 (1.5 to 2.0) times more likely to be smokers than those with college education, and women with no education were 3.7 (2.9 to 4.8) times more likely. Among smokers, 52.6% of men and 4.9% of women smoked only cigarettes while the others also smoked beedi or chutta. Compared with cigarette smokers, people smoking beedi or chutta were more likely to be older and married; have lower education, manual occupations, incomes, and body mass index; and not drink alcohol or take part in leisure exercise. Conclusion : There are two subpopulations of smokers in urban India, and the prevention strategy required for each may be different. The educated, white collar cigarette smoker in India might respond to measures that make non-smoking fashionable, while the less educated, low income people who smoke beedi or chutta may need strategies aimed at socioeconomic improvement. Key messages Lack of education was the strongest risk factor for smoking: men with no education were 1.8 times more likely to be smokers than those with college edu- cation, and women with no education were 3.7 times more likely There are two subpopulations of smokers in India: the affluent, white collar cigarette smoker and the less affluent labourer who smokes beedi or chutta Different preventive strategies may be required to target each of these two groups Prospective epidemiological studies of smoking in India will be of value