Tobacco smoking patterns, awareness and expenditure: a cross-sectional overview from Surat City, India


  • Kanan T Desai Department of Community Medicine, SMIMER, Surat, India
  • Vaibhav V Gharat Department of Community Medicine, SMIMER, Surat, India
  • Sunil N Nayak Department of Community Medicine, SMIMER, Surat, India
  • Prakash B Patel Department of Community Medicine, SMIMER, Surat, India
  • Rajkumar Bansal Department of Community Medicine, SMIMER, Surat, India


tobacco smoke, awareness, expenditure, bidi, India


BACKGROUND: As smoking is a major risk factor in India, the objective of present study was to assess smoking patterns, expenditure and awareness amongst smokers and to examine factors associated with the severity of smoking in Surat city.
METHODS: Community-based cross-sectional study was conducted with the use of pre-structured questionnaire tool targeting 281 current smokers in the slums of 20 Urban Health Centers. Smokers were categorized based on pack-years, which means the number of packs smoked per day multiplied by the duration of smoking (mild <5, moderate 5-15, and severe >15), and based on the number of cigarette/bidis smoked per day without the duration component (mild <10, moderate 10-19, and severe ≥20). Factors associated with severity of smoking were examined within two approaches with help of Epi-info mediated analysis.
RESULTS: Lower severity of smoking was associated with smaller number of family members who smoke (p<0.001). Groups of mild and moderate-severe smokers were similar with regards to education, socioeconomic class, and awareness regarding hazards of smoking (p>0.05). With the influence of friends (50%), about 60% smokers engage into this habit before the age of 20 years. Though only 20% of current smokers were not aware of the consequences of active smoking, more than 50% did not know about the same for passive smoking. The lowest socioeconomic class spends 44% of their income on tobacco products compared to 7% in the highest class.
CONCLUSION: The study provides insights for information, education and counseling (IEC) activities which should take into account health impact of bidi smoking, low awareness of health impact of passive smoking, and higher percentage of total monthly expenditure on tobacco among low-income household resulting in crowding out of expenditures on other needs.


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