Prevalence and Determinants of Smoking and Smokeless Tobacco in the Rural Population of Karnataka, India


  • Dinesh Rajaram Department of Community Medicine, M.S. Ramaiah Medical college and Hospital, Bengaluru, Karnataka, India
  • Shalini Chandrashekar Nooyi Department of Community Medicine, M.S. Ramaiah Medical college and Hospital, Bengaluru, Karnataka, India
  • Pruthvish Sreekantaiah Non-Communicable Diseases, Indian Council of Medical Research (ICMR), National Centre for Disease Informatics and Research, Bengaluru, Karnataka, India
  • Shalini Pradeep Department of Community Medicine, M.S. Ramaiah Medical college and Hospital, Bengaluru, Karnataka, India
  • Anjana George Department of Community Medicine, M.S. Ramaiah Medical college and Hospital, Bengaluru, Karnataka, India



Background: Tobacco is known as a major cause of various preventable non-communicable diseases and kills half of all its users. With a greater prevalence in the rural community compared to the urban, this global health burden is substantially malignant. This study aimed to bridge the gap in the lack of adequate statistical information pertaining to prevalence and determinants of smoking and smokeless tobacco use in the rural population of Karnataka.
Subjects and Method: This randomized community interventional study was conducted in primary health center areas of Karnataka, India. A total of 4,576 persons were interviewed (2,087 males and 2,489 females). Subjects ?30 years of age and residents for a minimum of six months were included. Mentally challenged, bedridden or differently abled subjects were excluded. The study employed a validated questionnaire adapted from the WHO STEPS questionnaire concerning demographical information, behavioral, physical, and biochemical measurements. Besides tobacco, informa-tion on use of beedis, cigarettes, and smokeless tobacco products (snuff, chewing tobacco) were also elicited. Data analysis of socio-demographic characteristics (age, educational/ marital/ occupational status) was carried out only for the participants with a current smoking habit. Data were analyzed using SPSS Version 18.0.
Results: The overall prevalence rate of current smoking and smokeless tobacco habit in the study population was 54.8% (95%CI= 53.40 to 56.20) and the prevalence rate of ever/past users was 39.7% (95%CI= 38.26 to 41.10). Genderwise analysis predicted a higher prevalence of males currently smoking, and among them, most were 50 to 59 years of age (43.3%), illiterate (42.7%), widowed/ separated (39.8%), unskilled (44%), and semi-skilled workers (30%).
Conclusion: Both genders participate in tobacco use, prevalence of smoking was higher among men and consumption of smokeless tobacco was higher among women. Subjects aged 50-59 years, illiterate, divorced/widowed/separated and, involved in unskilled or semi-skilled labor exhibited greater prevalence of tobacco habit compared to other determinants.
Keywords: noncommunicable diseases, global health, tobacco use, tobacco smoking, smokeless tobacco.

Correspondence: Dinesh Rajaram, Associate Professor. Department of Community Medicine, M.S. Ramaiah Medical college and Hospital, Bengaluru 560054, Karnataka, India. Email id.: Mobile: +919980336893.

Author Biography

Dinesh Rajaram, Department of Community Medicine, M.S. Ramaiah Medical college and Hospital, Bengaluru, Karnataka, India

Department of Community Medicine


Ansari ZA, Bano SN, Zulkifle M (2010). Prevalence of tobacco use among power loom workers-A cross-sectional study. Indian J Community Med. 35 (1): 34-39. doi: 10.4103/0970-0218.62551.

Bhavya B, Nisha C, Ankit S, Joseph EN, Anusha BK, Omkar P, Navya CJ, et al. (2015). Tobacco use among adults and its associated factors in a rural area in Karnataka, India J Hum Health. 1(2): 56-59.

Bhawna G (2013). Burden of smoked and smokeless tobacco consumption in India-results from the global adult tobacco survey India (GATS-India)-2009-2010. Asian Pac J Cancer Prev. 14 (5): 3323-3329. doi: 10.7314/apjcp.2013.14.5.3323.

Eek F, Östergren PO, Diderichsen F, Rasmussen NK, Andersen I, Moussa K, Grahn M (2010). Differences in socio-economic and gender inequalities in tobacco smoking in Denmark and Sweden; a cross sectional comparison of the equity effect of different public health policies. BMC Public Health 10 (1): 1-13. doi: 10.1186/1471-2458-10-9.

Fagan P, Shavers V, Lawrence D, Gibson JT, Ponder P (2007). Cigarette smoking and quitting behaviors among unemployed adults in the United States. Nicotine Tob Res. 9 (2): 241-248. doi: 10.1080/14622200601080331.

GSPS (2020). Global Tobacco Surveillance System (GTSS) - Global School Personnel Survey (GSPS). Available from: [Date of access: 6th July 2020]

Gupta V, Yadav K, Anand K (2010). Patterns of tobacco use across rural, urban, and urban-slum populations in a north Indian community. Indian J Community Med. 35 (2): 245-251. doi: 10.4103/0970-0218.66877.

Jangir NK, Singh A, Jain P, Khemka S (2021). The predictive value of depth of invasion and tumor size on risk of neck node metastasis in squamous cell carcinoma of the oral cavity: A pros-pective study. J Cancer Res Ther. doi: 10.4103/jcrt.JCRT_783_20.

Jha P, Jacob B, Gajalakshmi V, Gupta PC, Dhingra N, Kumar R, Sinha DN, et al. (2008). A nationally representative case–control study of smoking and death in India. New Engl. J. Med. 358 (11): 1137-1147. doi: 10.1056/NEJMsa-0707719.

Koh HK, Sebelius KG (2012) Ending the tobacco epidemic. JAMA. 308 (8): 767 -768. doi: 10.1001/jama.2012.9741.

Laaksonen M, Rahkonen O, Karvonen S, Lahelma E (2005). Socioeconomic status and smoking: analysing inequities with multiple indicators. Eur. J. Public Health 15 (3): 262-269. doi: 10.1093/eurpub/cki115.

Lee K, Freudenberg N, Zenone M, Smith J, Mialon M, Marten R, Lima JM, et al. (2022). Measuring the commercial determinants of health and disease: a proposed framework. Int. J. Health Serv. 52 (1) :115-128. doi: 10.1177/-00207314211044992.

Neelopant SA, Ashtagi GS (2016). Prevalence of smoking and smokeless forms of tobacco use in adults more than 18 years in an urban area. Int. J. Sci. Stu-dy 3 (11): 228-232. doi: 10.17354/ijss/2016/91.

Pednekar M, Nagler ME, Pawar P, et al. (2016). The prevalence of tobacco use among manufacturing workers: Findings from the baseline survey of the Mumbai worksite tobacco control study. Prev Med. 3: 1-10.

Prabhakar B, Narake SS, Pednekar MS (2012). Social disparities in tobacco use in India: the roles of occupation, education and gender. Indian J Cancer. 49 (4): 401-410. doi: 10.21767/2572-5483.100003.

Raj K, Chaurasia R, Singh AK (2021). Assessment of family welfare services with respect to couple-years of protection in a primary health center of Varanasi, Uttar Pradesh. J Public Health Prim Care. 2 (1): 10-14. doi: 10.4103/jphpc.jphpc_30_20.

Ruhil R (2019). Sociodemographic determinants of tobacco use in India: Risks of risk factor—An analysis of global adult tobacco survey India 2016-2017. SAGE Open 9 (2): 1-10. doi: 10.1177/2158244019842447.

Sinha DN, Palipudi KM, Gupta PC, Singhal S, Ramasundarahettige C, Jha P, Indrayan A, et al. (2014). Smokeless tobacco use: a meta-analysis of risk and attributable mortality estimates for India. Indian J Cancer 51 (5): 73-77. doi: 10.4103/0019-509X.147477.

Sinha DN, Singh G, Gupta PC, Pednekar M, Warrn CW, Asma S, Lee J (2010). Linking India global health professions student survey data to the world health organization framework convention on tobacco control. Indian J Cancer 47 (5): 30-34. doi: 10.4103/0019-509X.65177.

Sorensen G, Gupta PC, Pednekar MS (2005). Social disparities in tobacco use in Mumbai, India: the roles of occupation, education, and gender. Am J Public Health. 95(6): 1003-1008. doi: 10.2105/AJPH.2004.045039.

Thakur JS, Garg R, Narain JP, Menabde N (2011). Tobacco use: a major risk factor for non-communicable diseases in South-East Asia region. Indian J Public Health 55 (3): 155-160. doi: 10.41-03/0019-557X.89943.

Thankappan KR, Thresia CU (2007). Tobacco use & social status in Kerala. Ind J Med Res. 126 (4): 300-308.

Varghese C, Kaur J, Desai NG, Murthy P, Malhotra S, Subbakrishna DK, Prasad VM, et al. (2012). Initiating tobacco cessation services in India: challenges and opportunities. WHO South East Asia J Public Health 1(2): 159-168. doi: 10.4103/2224-3151.206929.

WHO (2020). Report on the Global Tobacco Epidemic, 2008: The MPOWER package. [Internet]. Available from:;jsessionid=3CC8CCEC95FBCE92F0B464EC2526A1E8?sequence=1. [Date of access: 6th July 2020]

WHO (2020). WHO STEPS Instrument Question-by-Question Guide (Core and Expanded). Available from: [Date of access: 6th July 2020].

Yuvaraj BY, Mane VP, Anilkumar L, Biradar M, Nayaka V, Sreenivasamurthy R (2020). Prevalence of consumption of smokeless tobacco products and exposure to second-hand smoke among women in the reproductive age group in a rural area of Koppal, Karnataka. Indian J. Community Med. 45 (1): 92-95. doi: 10.4103/ijcm.IJCM_88_19.


Additional Files



How to Cite

Rajaram, D., Nooyi, S. C., Sreekantaiah, P., Pradeep, S., & George, A. (2023). Prevalence and Determinants of Smoking and Smokeless Tobacco in the Rural Population of Karnataka, India. Journal of Epidemiology and Public Health, 8(1), 15–24.