BACKGROUND: India has largest number of SLT users around globe. It poses a significant public health challenge in India, contributing to a range of health problems, including oral cancers and cardiovascular diseases. Despite the known risks, its prevalence remains high, particularly among socioeconomically disadvantaged groups. This study investigates the socioeconomic disparities in smokeless tobacco consumption, focusing on the states of Himachal Pradesh, Punjab, Haryana, Uttarakhand, and Madhya Pradesh. Special attention is given to patterns among rural, lower-income, and less-educated populations. This study aims to analyse socioeconomic disparities in smokeless tobacco consumption across focused states, providing insights into the influence of education, income, occupation, and other factors using the NFHS data set.
METHODS: Descriptive statistics and logistic regression models are employed to identify significant predictors of smokeless tobacco use. Sampling weights provided by NFHS-5 are applied to ensure representativeness. Hypothesis testing evaluates disparities in consumption, with the null hypothesis (H0) stating no association between socioeconomic factors.
RESULTS: Preliminary analysis reveals significant associations between socioeconomic factors and smokeless tobacco consumption. Rural residents had higher odds of use (OR = 1.85, 95% CI: 1.65–2.06) compared to urban residents. Individuals from lower-income groups (OR = 2.34, 95% CI: 2.12–2.58) and those with less education (OR = 2.67, 95% CI: 2.42–2.94) were more likely to consume smokeless tobacco. Madhya Pradesh reported the highest prevalence, with marked disparities across gender (OR = 1.91, 95% CI: 1.70–2.14) and caste groups (OR = 1.73, 95% CI: 1.55–1.93). These findings highlight the substantial influence of socioeconomic status on smokeless tobacco use behaviors in India.
CONCLUSIONS: The findings reveal substantial socioeconomic and regional disparities in smokeless tobacco consumption, necessitating targeted public health interventions. Policies focusing on education, income support, and rural healthcare infrastructure are essential to curb smokeless tobacco use, particularly in high-prevalence regions like Madhya Pradesh.