Predictors of Cigarette Smoking Behavior in a Cohort of Adults in India
Prajakta Bhounsule, Susan Abughosh, E. James Essien, Sujit Sansgiry
Background: India is the second largest consumer of tobacco in the world. The disease burden, health care costs along with fiscal losses resulting from premature deaths attributable to tobacco consumption are increasing rapidly. This study aimed to identify and examine predictors of adult cigarette smoking behavior in India. Methods: A cross-sectional study utilizing a self-administered questionnaire was administered to a cohort of adults aged ≥18 years in 5 metropolitan cities in India. The outcome variable was current cigarette smoking status, where smoker were classified as current cigarette smoker who had used at least one cigarette during the last one month. Independent variables included socio-demographic characteristics and smoking status of peers. Descriptive and bivariate analyses followed by stepwise logistic regression were conducted to determine predictors of smoking. Results: The cohort comprised of 761 surveys (response rate 69%) among which 62.8% were current smokers. More than 50% of the smokers were males and had a bachelors’ degree, and were aged 30-39 and 40-49 years. Bivariate analysis indicated that age, marital status, education, income level, number of smoking friends, smoking status of father, siblings, close friends, and other individuals at home were associated with smoking. Stepwise logistic regression indicated that age groups 30-39 and 40-49, higher income categories >$10,000/yr - ≤$20,000/yr and >$ 20,000/yr, ≥2 smoking friends, and currently smoking individuals at home were predictors of smoking. Conclusion: Our findings suggest that age, income and number of friends and family members that smoke were associated with cigarette smoking behavior in the cohort of adults in India.