Publication:

Prevalence, pattern and determinants of tobacco use among persons of tribal origin in a primary care centre in Wayanad, Kerala

Background Persons of tribal origin account for over a quarter of India’s poorest people and also have a higher burden of disease attributable to adverse effects of tobacco use. Therefore, this study was planned in a health facility in Wayanad District to assess prevalence, pattern and determinants of tobacco use.

Methods A cross-sectional study was conducted among the persons of tribal origin by interview method using a pretested semi-structured questionnaire in a primary care facility in Wayanad, Kerala. Minimum sample size was calculated to be 140; 524 persons of tribal origin were enrolled. The chi-square test, logistic regression was used to determine association between qualitative variables.

Results Mean age of respondents was 42.52±16.95 years. The proportion of current tobacco users was found to be 39.1% (95% CI 34.9-43.4). Majority of respondents (90.2%) chewed tobacco, only 5.2% were smokers and 0.2% used other forms such as snuff. Of the tobacco users 81.95% had considered quitting. One in five persons, 19.9% used tobacco within 30 minutes of waking up. By logistic regression, men were found to be 2.59 times (95% CI 1.69, 3.97; p<0.001), illiterates 2.25 times (95% CI 1.51, .35; <0.001) and Paniya group 2.36 times (95% CI 1.6, 3.48) more likely to use tobacco.

Conclusions A high prevalence of tobacco use, early initiation and dependency, are a challenge to tobacco control among the socially and economically vulnerable indigenous people. However, the desire and attempts made to quit tobacco can be leveraged for harm reduction and tobacco cessation among males, Paniyas and illiterate people.