Prevalence and patterns of smoking in Delhi: cross sectional study

BMJ 1996;312:1576-1579 (22 June)

Papers

Prevalence and patterns of smoking in Delhi: cross sectional study

K M Venkat Narayan, visiting scientist,^a S L Chadha, community health specialist,^b R L Hanson, senior staff fellow,^a R Tandon, consultant cardiologist,^b S Shekhawat, statistician,^b R J Fernandes, visiting fellow,^a N Gopinath, director ^b

^a Diabetes and Arthritis Epidemiology Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ 85014, USA, ^b Sitaram Bhartia Institute of Science and Research, B-16 Mehrauli Institutional Area, New Delhi-16, India

Correspondence to: Dr Venkat Narayan.

Abstract

Objective: To determine the prevalence and predictors of smokingin urban India.
Design: Cross sectional.
Setting: Delhi, urban India, 1985-6.
Subjects: Random sample of 13 558 men and women aged 25-64 years.
Main outcome measure: Smoking prevalence; subjects who werecurrently smoking and who had smoked >/=100 cigarettes orbeedis or chuttas in their lifetime were defined as smokers.
Results: 45% (95% confidence interval 43.8 to 46.2) of men and7% (6.4 to 7.6) of women were smokers. Education was the strongestpredictor of smoking, and men with no education were 1.8 (1.5to 2.0) times more likely to be smokers than those with collegeeducation, and women with no education were 3.7 (2.9 to 4.8)times more likely. Among smokers, 52.6% of men and 4.9% of womensmoked only cigarettes while the others also smoked beedi orchutta. Compared with cigarette smokers, people smoking beedior chutta were more likely to be older and married; have lowereducation, manual occupations, incomes, and body mass index;and not drink alcohol or take part in leisure exercise.
Conclusion: There are two subpopulations of smokers in urbanIndia, and the prevention strategy required for each may bedifferent. The educated, white collar cigarette smoker in Indiamight respond to measures that make non-smoking fashionable,while the less educated, low income people who smoke beedi orchutta may need strategies aimed at socioeconomic improvement.

Key messages

Lack of education was the strongest risk factor for smoking: men with no education were 1.8 times more likely to be smokers than those with college edu- cation, and women with no education were 3.7 times more likely
There are two subpopulations of smokers in India: the affluent, white collar cigarette smoker and the less affluent labourer who smokes beedi or chutta
Different preventive strategies may be required to target each of these two groups
Prospective epidemiological studies of smoking in India will be of value

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