Smokeless tobacco use among adult males in India and selected states: Assessment of education and occupation linkages

This article is an effort to analyze the influence of education and occupation as critical determinants of smokeless tobacco use among adult males in India and its selected states. Global Adult Tobacco Survey (GATS) India 2009–10 data are used to analyze the prevalence of smokeless tobacco use among adult males aged 15 years and above (N = 33,767) by their different education and occupational status. Bivariate and multivariate (Cox proportional survival model) analyses are carried out to assess the linkages of education and occupation with use of smokeless tobacco among adult males. The study suggests that the majority of Indian men are using khaini (18%) and gutkha (13%) (the local terms used for smokeless tobacco). Further, it is observed that education and occupation remain the two important critical predictors of smokeless tobacco use among men. A greater percentage of young men with no education from rural areas use smokeless tobacco (44.3%) than their counterpart group from urban areas. The socioeconomically disadvantaged states, noticeably the east and central (4.992 and 3.218; p < .001) states, record higher prevalence of smokeless tobacco use than other states. Considering the high prevalence of smokeless tobacco use among illiterate and socioeconomically deprived youths, there is an urgent need to sensitize the issue. More concrete efforts to generate awareness on the ill effects of tobacco use among the illiterate and those who are employed in low-profile occupations are needed.