BACKGROUND: Tobacco use remains a significant public health concern in India, contributing substantially to the burden of multiple long-term conditions (MLTCs). MLTCs defined as the co-occurrence of two or more chronic conditions, presents complex challenges for the healthcare system. This study aims to examine the association between the tobacco use (smoking, smokeless tobacco (SLT) or both) and MLTCs in India.
METHODS: We analysed nationally representative data from the Longitudinal Aging Study in India (LASI) (2017–2018), encompassing 65,562 individuals aged 45 years and above. Weighted prevalence and adjusted odds ratios (AOR) with 95% confidence intervals (CI) were estimated (multivariable logistic regression) to assess the association between tobacco use, and occurrence of MLTCs.
RESULTS: Among participants, 36.79% consumed tobacco: 13.92% smoked, 19.89% used SLT, and 2.98% were dual users. Among socio-economic factors, age strongly influenced the prevalence of MLTCs, with individuals aged 60–74 years having 83% higher odds (AOR: 1.83; 95% CI: 1.70–1.97) and those above 74 years showing 144% higher odds (2.44; 2.17–2.75). Females had 60% higher odds of MLTCs than males (1.60; 1.45–1.76). People belonging to the scheduled tribes had lower odds (0.73; 0.66–0.82), while no significant differences were observed among scheduled caste and other backward classes. Smoking emerged as a significant behavioural predictor of MLTCs (1.17; 1.06–1.29), with dual usage showing a stronger association (1.42; 1.20–1.68). SLT use was not significantly associated with MLTCs (1.06; 0.98–1.14).
CONCLUSIONS: Dual use of tobacco smoking and SLT or smoking alone increased the risk of MLTCs. There is a need to step up cessation through community engagement and involvement and adopt innovative models of tobacco control that leverage community-based approaches alongside the services provided at the health system level.