Geographic variation in tobacco use in India: a population-based multilevel cross-sectional study

Abstract

OBJECTIVE: This study aims to quantify the extent to which people's use of tobacco products varies by local areas (city ward and village) across India and the variation in this clustering by tobacco products. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Data on 73 954 adults across 2547 city wards and villages were available for analysis from 30 states and 2 union territories in India. PRIMARY AND SECONDARY OUTCOME MEASURES: We included as primary outcomes self-reported any tobacco use, current cigarette smoking, current bidi smoking, current smokeless tobacco use and a derived variable for dual use describing respondents who engaged in both smoking and smokeless tobacco use. RES..