Social, behavioral and environmental correlates of tobacco use among adults in a tribal population in northern India
- 1Department of Community & Family Medicine, All India Institute of Medical Sciences
- 2Independent Researcher
- 3All India Institute of Medical Sciences
Abstract
Background: Tobacco use remains a leading preventable cause of morbidity and mortality worldwide and disproportionately affects socially and economically marginalized populations. Although national surveys provide overall prevalence estimates, evidence on the socio-demographic, behavioral, and environmental correlates of tobacco use in underserved tribal communities remains limited. This study examined the prevalence and correlates of tobacco use among adults residing in tribal villages in northern India.
Methods: A community-based cross-sectional study was conducted among adults aged ≥20 years residing in five tribal villages of Gorakhpur district, northern India. A complete household enumeration was undertaken between March and June 2024. Data were collected using a structured questionnaire covering socio-demographic characteristics, alcohol consumption, household smoking exposure, and workplace smoking exposure. Current tobacco use (smoked or smokeless) was self-reported. Associations between explanatory variables and tobacco use were assessed using chi-square tests and multivariable logistic regression to estimate adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Model calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test and receiver operating characteristic (ROC) curve analysis was conducted as a supplementary exploratory assessment of model discrimination.
Results: A total of 2,236 adults participated in the study. The overall prevalence of current tobacco use was 10.7%. Tobacco use was significantly higher among men than women (17.9% vs. 2.4%; p < 0.001) and increased with advancing age. After adjustment, male sex (AOR 2.12, 95% CI 1.08–4.18), older age (≥60 years: AOR 3.42, 95% CI 1.67–6.99), and workplace smoking exposure (AOR 3.19, 95% CI 1.70–6.00) remained independently associated with tobacco use. Although occupational category and household smoking exposure were significant in unadjusted analyses, these associations were attenuated after multivariable adjustment. The final model demonstrated good calibration (Hosmer–Lemeshow p = 0.059) and high apparent discriminatory performance (AUC 0.93, 95% CI 0.91–0.95).
Conclusion: Tobacco use in this tribal population was associated with gender, older age, and workplace smoking exposure. The independent association between workplace smoking exposure and tobacco use supports consideration of strengthened smoke-free workplace policies, particularly within informal labor settings. Integrating tobacco-control interventions with community-based behavioral risk reduction strategies through primary healthcare systems may help reduce tobacco-related disparities in underserved tribal populations.
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BibTeX
@article{venkatesh2026social,
title = {{Social, behavioral and environmental correlates of tobacco use among adults in a tribal population in northern India}},
author = {U. Venkatesh and Arshad Ahmed and R. Durga and Anand Mohan Dixit and Vibha Dutta},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1927436},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1927436/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Social, behavioral and environmental correlates of tobacco use among adults in a tribal population in northern India
AU - U. Venkatesh
AU - Arshad Ahmed
AU - R. Durga
AU - Anand Mohan Dixit
AU - Vibha Dutta
PY - 2026
DA - 2026/10/08
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1927436
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1927436/full
AB - Background: Tobacco use remains a leading preventable cause of morbidity and mortality worldwide and disproportionately affects socially and economically marginalized populations. Although national surveys provide overall prevalence estimates, evidence on the socio-demographic, behavioral, and environmental correlates of tobacco use in underserved tribal communities remains limited. This study examined the prevalence and correlates of tobacco use among adults residing in tribal villages in northern India. Methods: A community-based cross-sectional study was conducted among adults aged ≥20 years residing in five tribal villages of Gorakhpur district, northern India. A complete household enumeration was undertaken between March and June 2024. Data were collected using a structured questionnaire covering socio-demographic characteristics, alcohol consumption, household smoking exposure, and workplace smoking exposure. Current tobacco use (smoked or smokeless) was self-reported. Associations between explanatory variables and tobacco use were assessed using chi-square tests and multivariable logistic regression to estimate adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Model calibration was assessed using the Hosmer–Lemeshow goodness-of-fit test and receiver operating characteristic (ROC) curve analysis was conducted as a supplementary exploratory assessment of model discrimination. Results: A total of 2,236 adults participated in the study. The overall prevalence of current tobacco use was 10.7%. Tobacco use was significantly higher among men than women (17.9% vs. 2.4%; p < 0.001) and increased with advancing age. After adjustment, male sex (AOR 2.12, 95% CI 1.08–4.18), older age (≥60 years: AOR 3.42, 95% CI 1.67–6.99), and workplace smoking exposure (AOR 3.19, 95% CI 1.70–6.00) remained independently associated with tobacco use. Although occupational category and household smoking exposure were significant in unadjusted analyses, these associations were attenuated after multivariable adjustment. The final model demonstrated good calibration (Hosmer–Lemeshow p = 0.059) and high apparent discriminatory performance (AUC 0.93, 95% CI 0.91–0.95). Conclusion: Tobacco use in this tribal population was associated with gender, older age, and workplace smoking exposure. The independent association between workplace smoking exposure and tobacco use supports consideration of strengthened smoke-free workplace policies, particularly within informal labor settings. Integrating tobacco-control interventions with community-based behavioral risk reduction strategies through primary healthcare systems may help reduce tobacco-related disparities in underserved tribal populations.
SN - 2296-2565
ER -