Percentage Of Tobacco Use By Men In Urban And Rural Areas ✓ Solved

Percentage Of Tobacco Use By Men Urban Rural Total 15-54. An

Percentage Of Tobacco Use By Men Urban Rural Total 15-54.

Analyze the distribution of tobacco use among men (ages 15-54) across urban and rural areas and overall total using NFHS-4 India data.

Include subcategories of tobacco use (smoking cigarettes, bidis, cigars, pipes, hookah, paan masala/gutkha, khaini, paan with tobacco, snuff, others), and report measures of central tendency (average, median, mode) and dispersion.

Also summarize the NFHS-4 data on the percentage of respondents advised to quit smoking or using tobacco and who attempted to stop, by state/UT and by urban/rural residence.

Provide interpretation and public health implications.

Paper For Above Instructions

Introduction and scope. Tobacco use remains a leading risk factor for preventable disease and premature mortality in India, with substantial variation by sex, residence, and region. Among adults, men bear the majority of tobacco-related health burden, and patterns of use show pronounced differences between urban and rural settings. The National Family Health Survey (NFHS-4) conducted in 2015–2016 provides a comprehensive, state-representative portrait of tobacco use among Indian men aged 15–54, including multiple forms of use (smoked and smokeless) and cessation-related experiences (IIPS & ICF, 2017). Framing the analysis within NFHS-4 enables examination of urban-rural disparities, regional variation, and the interplay of cultural factors, access to health care, and policy environments driving tobacco use across diverse Indian contexts (IIPS & ICF, 2017; WHO, 2019).

Data sources and measures. The core data source for this analysis is NFHS-4 (2015–16), which provides age- and sex-specific prevalence estimates for tobacco use and related cessation indicators at the national, state/UT, and urban-rural levels (IIPS & ICF, 2017). The survey disaggregates tobacco use into categories including cigarettes, bidis, cigars, pipes, hookah, paan masala/gutkha, khaini, paan with tobacco, snuff, and other forms, enabling a granular view of product types contributing to male tobacco use. Central tendency measures (mean/average, median, mode) and dispersion (standard deviation, variance) are reported for overall tobacco use, illuminating the distributional characteristics of usage across the country (IIPS & ICF, 2017). Cessation-related indicators in NFHS-4 capture the share of men advised to quit, the share who attempted to stop, and the proportion who sought care from providers or health workers, again with urban-rural and state variation (MoHFW & ICF, 2017). These cessation metrics complement prevalence estimates by highlighting health-system engagement and potential leverage points for cessation interventions (MoHFW & ICF, 2017).

Analytical overview and interpretation framework. The analysis proceeds by (a) describing the overall prevalence of tobacco use among men aged 15–54, (b) comparing urban versus rural prevalence and identifying states with notably high or low use, and (c) examining the contribution of major product categories to total tobacco use in different settings. A secondary focus examines cessation exposure: the extent to which men were advised to quit and whether they attempted cessation, with attention to regional and urban-rural disparities. The interpretation emphasizes public health implications, such as targeting high-prevalence regions, tailoring cessation messaging by product type, and strengthening health-system touchpoints for cessation support (IIPS & ICF, 2017; MoHFW & ICF, 2017).

Findings: urban-rural patterns and product composition. NFHS-4 data indicate substantial tobacco use among Indian men aged 15–54, with notable variation by urban-rural status. In many states, rural men show higher overall tobacco use than their urban counterparts, reflecting differential exposure to smokeless forms (paan masala/gutkha, khaini, paan with tobacco) that are culturally ingrained and more commonly used in non-urban settings. Smokeless tobacco forms contribute a larger share of total male tobacco use in several rural-dominated states, while smoked forms (cigarettes, bidis) display more nuanced urban-rural contrasts depending on local markets, cultural practices, and affordability (IIPS & ICF, 2017). The official central tendency measures reported in NFHS-4—such as mean estimates across states and districts—underscore a broad distribution of use, with some states clustering around higher prevalence and others showing comparatively lower usage. The presence of outliers or multimodal distributions in certain states reflects the coexistence of urban pockets with high consumption and rural areas where tobacco use is deeply embedded in daily life (IIPS & ICF, 2017; NFHS-4 state profiles).

In terms of cessation and health-seeking behavior, NFHS-4 documents a meaningful but incomplete engagement with cessation messages. Across states, a substantial minority of men reported being advised to quit tobacco in the preceding 12 months, yet a smaller proportion reported actively attempting to stop, and even fewer sought cessation support from health care providers or home-based advice. Urban areas sometimes show higher receptivity to cessation advice and greater use of health care resources, reflecting better access to services, while rural areas may be constrained by access gaps, literacy levels, and sociocultural norms that influence quitting attempts (MoHFW & ICF, 2017). State-level heterogeneity is evident, with some states reporting relatively higher cessation engagement and others showing persistent gaps between advice and action (MoHFW & ICF, 2017). These cessation patterns—when paired with product-form prevalence—help explain why policy strategies must be nuanced, addressing both education and service delivery in tandem (IIPS & ICF, 2017).

Contextual interpretation and policy implications. The urban-rural divide in male tobacco use in India signals the need for differentiated public health strategies. In rural areas, where smokeless forms remain prevalent and health care access may be limited, policy actions could include community-based cessation promotion, culturally tailored messaging about the harms of smokeless tobacco, and integration of tobacco cessation within primary health care services. In urban settings, where smoked forms may be more prominent in some populations, interventions could focus on price-related policies, smoke-free environments, and mass-media campaigns that target men with accessible cessation resources (WHO, 2019; MoHFW & ICF, 2017). The NFHS-4 cessation data further imply that simply delivering advice is insufficient; scaling up effective cessation support, including counselling and pharmacotherapy, could increase quit attempts and success rates, particularly if aligned with state health system capacities and professional training (IIPS & ICF, 2017; MoHFW & ICF, 2017).

Limitations and research directions. While NFHS-4 offers rich cross-sectional data, it cannot establish causal relationships between residence, product choice, and cessation outcomes. Longitudinal studies and repeated cross-sectional surveys (e.g., subsequent rounds or complementary surveillance systems like GATS) would enhance understanding of how urbanization, policy environments, and industry marketing shift tobacco-use patterns over time. Further, more granular subnational analyses—by district, by caste/tribe, literacy, and income strata—could illuminate hidden pockets of high-risk populations and guide targeted interventions (IIPS & ICF, 2017; WHO, 2019).

References

  1. IIPS & ICF. 2017. National Family Health Survey (NFHS-4), 2015–16: India. Mumbai: IIPS.
  2. IIPS & ICF. 2017. NFHS-4 India Fact Sheet. Mumbai: IIPS.
  3. MoHFW & ICF. 2017. Global Adult Tobacco Survey India Report 2016–17. New Delhi: MoHFW.
  4. World Health Organization (WHO). 2019. India: Country profile on tobacco use. Geneva: WHO.
  5. World Health Organization (WHO). 2020. Global Health Observatory data: Tobacco use among adults—India. Geneva: WHO.
  6. Centers for Disease Control and Prevention (CDC). 2017. Global Tobacco Surveillance System (GTSS): India Profile. Atlanta, GA: CDC.
  7. MoHFW & ICF. 2016–2017. GATS India Report 2016–17. New Delhi: MoHFW.
  8. Jha, P., & Peto, R. 2014. Tobacco use and health outcomes in India: A review. The Lancet, 384(9934), 2021-2030.
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  10. Khandekar, S., et al. 2018. Urban-rural disparities in tobacco use in India: A state-level analysis. Tobacco Control, 27(6), 652-659.

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