Tobacco use among Indian states: Key findings from the latest demographic health survey 2019–2020

Tobacco use is associated with accelerated mortality among adults especially in low-and middle-income countries, where the burden of tobacco-related illness and death is heaviest 1 . More than 1 million adults die each year in India due to tobacco use accounting for 9.5% of overall deaths 2 . India faces a dual burden of tobacco use in the form of smoking and smokeless tobacco. According to the Global Adult Tobacco Survey (GATS) conducted in 2016-17, the overall prevalence of smoking tobacco use is 10.38% and smokeless tobacco use is 21.38% in India. Of all adults, 28.6% currently consume tobacco either in smoke or smokeless form, including 42.4% of men and 14.2% of women 3 . The Demographic Health Survey, known as the National Family Health Survey (NFHS) is one of the largest health surveys conducted in India providing disaggregate estimates of several health and demographic indicators. It has been a major source for planning policies and programs for different aspects of health among the Indian population. As NFHS and GATS are nationally representative household surveys using multistage sampling design with an overall response rate of >90%; they produce enough sample size for reliable estimates to be made, at least at state level, for comparison.