Patterns and related factors of bidi smoking in India
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Global Tobacco Control Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, United States
World Health Organization Country Office, New Delhi, India
School of Preventive Oncology, Patna Medical College, Patna, India
Healis–Sekhsaria Institute of Public Health, Navi Mumbai, India
Ministry of Health and Family Welfare, Government of India, New Delhi, India
Lazarous Mbulo   

Global Tobacco Control Branch, Office on Smoking and Health, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F-79, Atlanta, GA 30341, United States
Publication date: 2020-05-04
Submission date: 2019-12-18
Final revision date: 2020-02-29
Acceptance date: 2020-03-16
Tob. Prev. Cessation 2020;6(May):28
Bidis are the most commonly smoked tobacco product in India. Understanding bidi smoking is important to reducing overall tobacco smoking and health-related consequences in India. We analyzed 2009–2010 and 2016– 2017 Global Adult Tobacco Survey (GATS) India data to examine bidi smoking and its associated sociodemographic correlates and perceptions of dangers of smoking.

GATS is a nationally representative household survey of adults aged ≥15 years, designed to measure tobacco use and tobacco control indicators. Current bidi smoking was defined as current smoking of one or more bidis during a usual week. We computed bidi smoking prevalence estimates and relative change during 2009–2010 and 2016–2017. Used pooled multilevel logistic regression to identify individual-level determinants of bidi smoking and neighborhood-level and state-level variations.

Overall, 9.2% and 7.7% of adults smoked bidis in India during 2009–2010 and 2016–2017, respectively, reflecting 16.4% significant relative decline. In pooled analysis, male, older age, rural residence, lower education level, lower wealth index, less knowledge about harms of smoking, and survey year were associated with increased odds of bidi smoking. Results also showed variance in odds of smoking bidis is associated with neighborhood (15.9%) and state (31.8%) level.

Higher odds of bidi smoking were found among males, older age groups, and among those with lower socioeconomic status. Accordingly, health education interventions designed for these groups across India and other population-level interventions, such as WHO recommendation on increasing price on tobacco products, could help reduce bidi smoking. In addition, state/ neighborhood-specific interventions could also help address differential bidi smoking across India.

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
There was no source of funding for this research.
Not commissioned; externally peer reviewed.
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