Tobacco cessation among dual users: analysis of two rounds of Global Adult Tobacco Survey, India.

Abstract

Objective: The tobacco epidemic in India involves extensive use of smoking and smokeless tobacco products, with nearly 24 million dual users (using both forms) in 2016-17. Tobacco cessation among dual users remains underexplored. This study examines the pattern and determinants of tobacco cessation among dual users using the transtheoretical model.

Methods: Data from two rounds of the Global Adult Tobacco Survey, India (2009-10 and 2016-17) were used (pooled sample of 6956 current dual users) to estimate the prevalence of tobacco cessation stages (precontemplation, contemplation, preparation, and relapse). We modelled association with cessation stages using multinomial logistic regression.

Results: About 43% of dual users were in precontemplation, 10% in contemplation, 23% in preparation, and 24% in relapse in 2009-10. These proportions shifted to 48%, 8%, 17%, and 27%, respectively, in 2016-17. The regression model indicated significant temporal influence, with dual users in 2016-17 more likely to be in precontemplation [relative risk ratio (RRR): 1.59], contemplation (RRR: 1.37), and relapse (RRR: 1.88) than in 2009-10. Age, gender, wealth quintile, region, and exposure to tobacco-related health warnings were significant predictors.

Conclusion: Addressing dual tobacco use requires targeted cessation interventions that consider regional and contextual factors to support users through the stages of readiness to quit.