Correlation between Multi-dimensional Poverty and Tobacco Use in Indian States: An Ecological Study

Worldwide research has shown the harmful effects of tobacco use on our health. There are social and economic situations where individuals are more likely to use tobacco as compared to their counterparts. In India, tobacco use has been studied in relation to socioeconomic disadvantage by several researchers. All these studies took only the economic and material aspects of socioeconomic disadvantage. Rarely has any study correlated tobacco use with multidimensional poverty. Thus, this paper aims to see the correlation between multidimensional poverty and tobacco use. This study utilised an ecological design to identify associations between the aggregate use of tobacco and the multidimensional poverty index. Aggregate data related to tobacco use in any form, the Percentage of current smokers, and the Percentage of current smokeless tobacco (SLT) users in various states of India were taken from Global Adult Tobacco Survey (GATS) India 2016-17. Aggregate data related to headcount ratio as per the national multidimensional poverty index (MPI) was taken from the Baseline Report of Niti Aayog, Govt. of India, published in 2021. Pearson correlation was used to associate tobacco use with a multidimensional poverty index. We performed a linear regression model to assess whether multidimensional poverty was associated with tobacco use, including its smoking and smokeless forms. There is a positive correlation between the multidimensional poverty index and tobacco use, especially the forms of smokeless tobacco use. Thus, poverty and tobacco use form a vicious cycle. Low-income people tend to smoke/chew more; they tend to suffer more, spend more on tobacco-related illnesses and die due to tobacco-related illnesses. It is likely that deprivation affects the risk of smoking/SLT use at different stages: First by increasing the susceptibility to initiation of tobacco use habit, second by increasing the levels of nicotine dependence, and third by reducing the chances of successful quitting. Thus, there is a need to integrate the work done for the reduction of poverty by several communities, governments, donors, health professionals and others; with the work to reduce tobacco use. Civil society organisations and other governmental and non-governmental organisations working towards improving lives; should also work towards reducing tobacco use and vice versa.