Assessment of nicotine dependence among tobacco users in a rural area of Salem, Tamilnadu: Community based cross sectional study.

Background: India is the 2^nd largest consumer of tobacco worldwide. Tobacco use for longer duration leads to nicotine dependance and also increases the chances of dependance to other substances Morbidity and mortality rates are increasing due to tobacco use.

Objectives: 1. To estimate the prevalence of physical and psychological nicotine dependance among tobacco users in rural area. 2. To determine the factors associated with of physical and psychological nicotine dependance among tobacco users in rural area.

Materials and methods: It is a community-based analytical cross-sectional study conducted among 405 tobacco users (>18 years) in the field area of a Medical College in Tamil Nadu. A pre-tested structured questionnaire was used to collect data including Fagerstrom physical nicotine dependance scale and TAPDS psychological dependance scale. The data was entered in MS Excel and analysis was done using SPSS software (version 22).

Results: Mean age was 36 ± 11.2 Years and 284 (70.1%) were males. Nearly 270 (66.7%) use smoked form of tobacco, and 88 (21.7%) were using tobacco for ≥10 Years About 179 (44.1%) and 120 (29.6%) had high and moderate physical dependence respectively. Also, 127 (31.3%) had mild psychological dependence. In binary logistic regression analysis, high physical nicotine dependance was significantly associated with male, age of initiation of tobacco use <30 Years, and ≥10 Years of tobacco use. Psychological nicotine dependance was associated with male gender and ≥10 Years of tobacco use.

Conclusion: Even though many legislative measures and acts were passed by the government nicotine dependance prevalence was high in this area. Lifestyle modification plays a key role in nicotine dependance, and change in the harmful lifestyle habits must be adopted. The target population for this strategy will be adolescents and early adults.