Prevalence and factors associated with tobacco use among beneficiaries attending the youth mental health promotion clinics (Yuvaspandana Kendra) in India: A case-record analysis

Abstract

INTRODUCTION Chewing tobacco and smoking among youth leads to poor health outcomes. Understanding the factors associated with chewing tobacco and smoking is thus important for interventions. METHODS A case-record analysis among 10340 youth (aged 15-35 years) attending a unique mental health promotion program, Yuva Spandana, across the state of Karnataka in southern India, was performed to assess prevalence of chewing tobacco and smoking. Multiple logistic regression was applied to determine the factors associated with their use. RESULTS Overall, the prevalence of chewing tobacco and smoking among beneficiaries was 3% and 2.1%, respectively. The risk of tobacco chewing and smoking increased with age and risk was higher among males, married individuals and among all occupational categories, other than students. Adjusted odds ratios of chewing tobacco were found to be highest among business/salaried beneficiaries (AOR=3.48; 95% CI: 2.27-5.34), followed by ever married beneficiaries (AOR=3.41; 95% CI: 1.27-9.17). Adjusted odds ratios of smoking tobacco were highest among males (AOR=12.89; 95% CI: 7.5-22.14), followed by emotional experience of feeling worthless (AOR=4.19; 95% CI: 2.78-6.32), beneficiaries with poor relationship with family members (AOR=3.79; 95% CI: 1.38-10.44), and business/salaried beneficiaries (AOR=2.90; 95% CI: 1.79-4.7). Strength of association of males with smoking was much higher (AOR=12.89; 95% CI: 7.5-22.14) than compared with chewing tobacco (AOR=2.49; 95% CI: 1.89-3.28). CONCLUSIONS Early identification of these factors associated with chewing tobacco and smoking will help in focusing on youth specific health promotion and interventions to improve their overall health and wellbeing.

Nicotine prevalence among youth of rural Jaipur, Rajasthan

“…[ 2 1 ] The reasons might be the usual false perceptions that a smoking man: is “successful, intelligent and macho,” “risk-taking,” and has “strong masculinity,” and that chewing tobacco leads to ‘better athletic performance’ and “rule-breaking risks” in contrast to females who are perceived as culturally unacceptable in Indian societies if they smoke or chew tobacco. [ 6 ]…”

“…[ 4 ] Chewing tobacco increases the risk of cancers of the oral cavity (including cancer of the mouth, tongue, lip, and gums), throat, and esophagus, as well as leading to various oro-dental diseases. [ 6 ]…”

“…Chewing nicotine and smoking have profound public health implications in terms of cardiovascular diseases, cancers, and neurological disorders that create a burden on the individual, family, society, and economy. [ 6 ] Early age of initiation of nicotine use drives its epidemic. Nicotine use among youth is associated with multi-factorial etiology.…”