A cross-sectional study of the prevalence and correlates of tobacco use in Chennai, Delhi, and Karachi: data from the CARRS study
Open accessAbstract
BACKGROUND: Tobacco burdens in India and Pakistan require continued efforts to quantify tobacco use and its impacts. We examined the prevalence and sociodemographic and health-related correlates of tobacco use in Delhi, Chennai (India), and Karachi (Pakistan). METHODS: Analysis of representative surveys of 11,260 participants (selected through multistage cluster random sampling; stratified by gender and age) in 2011 measured socio-demographics, tobacco use history, comorbid health conditions, and salivary cotinine. We used bivariate and multivariate regression analyses to examine factors associated with tobacco use. RESULTS: Overall, 51.8 % were females, and 61.6 % were below the age of 45 years. Lifetime (ever) tobacco use prevalence (standardized for world population) was 45.0 %, 41.3 %, and 42.5 % among males, and 7.6 %, 8.5 %, and 19.7 % among females in Chennai, Delhi, and Karachi, respectively. Past 6 month tobacco use prevalence (standardized for world population) was 38.6 %, 36.1 %, and 39.1 % among males, and 7.3 %, 7.1 %, and 18.6 % among females in Chennai, Delhi, and Karachi, respectively. In multivariable regression analyses, residing in Delhi or Karachi versus Chennai; older age; lower education; earning less income; lower BMI; were each associated with tobacco use in both sexes. In addition, semi-skilled occupation versus not working and alcohol use were associated with tobacco use in males, and having newly diagnosed dyslipidemia was associated with lower odds of tobacco use among females. Mean salivary cotinine levels were higher among tobacco users versus nonusers (235.4; CI: 187.0-283.8 vs. 29.7; CI: 4.2, 55.2, respectively). CONCLUSION: High prevalence of tobacco use in the South Asian region, particularly among men, highlights the urgency to address this serious public health problem. Our analyses suggest targeted prevention and cessation interventions focused on lower socioeconomic groups may be particularly important.
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This study's findings on correlates of tobacco use align with prior research.
“our study aligns with prior research (30, 38–40).”
A positive relationship between tobacco use and low socioeconomic status is in agreement with Western findings and findings from other developing nations.
“our result with respect to a positive relationship between tobacco use and low socioeconomic status is in agreement with Western findings (44) as well as findings from other developing nations (30, 38, 39).”
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- Authors
- Berg, C. J., Ajay, V. S., Ali, M. K., Kondal, D., Khan, H. M., Shivashankar, R., Pradeepa, R., Mohan, D., Fatmi, Z., Kadir, M. M., Tandon, N., Mohan, V., Narayan, K. V., & Prabhakaran, D.
- Affiliations
- Emory University (US)
- Centre for Chronic Disease Control (IN)
- Aga Khan University (PK)
- Madras Diabetes Research Foundation (IN)
- All India Institute of Medical Sciences (IN)
- Corresponding author
- Berg, Carla J
- ORCID
- Venue
- BMC Public Health
- Published
- 2015-05-11
- Volume
- 15
- Issue
- 1
- Pages
- 483-483
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC4432508
- OpenAlex
- W1507299556
- Cited by
- 22
- References
- 47
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 7 · 2018: 2 · 2017: 4 · 2016: 2
- FWCI
- 1.97
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Health and Human Services (HHSN268200900026C)
- Vanderbilt University (1D43HD05249)
- Emory University
- Public Health Foundation of India
- All-India Institute of Medical Sciences
- Madras Diabetes Research Foundation
- National Institutes of Health (HHSN268200900026C)
- U.S. Public Health Service (HHS N268200900026C)
- National Heart, Lung, and Blood Institute (HHSN268200900026C)
- Fogarty International Center (1D43HD05249, R24TW007988)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (1D43HD05249)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Keywords
- tobacco use, prevalence, sociodemographic correlates, salivary cotinine, South Asia, India, Pakistan, gender differences, socioeconomic status, alcohol consumption, dyslipidemia, Chennai, Delhi, Karachi
- MeSH terms
- Adolescent, Adult, Alcohol Drinking, Cross-Sectional Studies, Female, Health Status, Humans, India, Male, Middle Aged, Pakistan, Poverty, Tobacco Use Disorder, Comorbidity, Prevalence, Sex Distribution, Tobacco Use
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