Journal of Public Health

, Volume 26, Issue 2, pp 195–204 | Cite as

Behavioral risk factors and non-communicable diseases among adult men in demographically developed states of India: evidence from District Level Household and Facility Survey-4

  • Shri Kant Singh
  • Swati Srivastava
Original Article



To examine the association between behavioral habits (alcohol consumption, smoking, and chewing tobacco) and non-communicable diseases (NCDs) among adult males (18 years and above) in demographically developed states of India.

Subjects and methods

The latest round of the District Level Household and Facility Survey (2012–2013) and multivariate logistic regression model was carried out to accomplish the objective.


The analysis reveals that alcohol consumption significantly increases the risk of the respiratory infection and hypertension. However, smoking and smokeless tobacco do not show a significant association with the set of NCDs included in this analysis. Moreover, the adjusted effect of the regression model shows that alcohol consumption, smoking, chewing tobacco, age and BMI are the major risk factors for the occurrence of NCDs among males in states in India.


The findings are vital for national commitments and policy instruments, especially in the context of the existing epidemiological transition, which are burdened with a high occurrence of NCDs. They clearly demand programs and services targeting individuals with increased risk of alcohol consumption, a combination of tobacco and alcohol use, and users of multiple substances. It is worth to mentioning that NCDs are a crude measures that does not reveal the reason for the disease. Alcohol consumption, smoking, and chewing tobacco have the lifetime exposure, but NCDs are recurrent events. Therefore, it is recommended that the relationship between behavioral habits and NCDs should be analyse by using longitudinal data instead of cross-sectional data.


Non-communicable disease Behavioral habits CAB component Multivariate regression analysis 



Non-communicable diseases


District Level Household and Facility Survey


Clinical, anthropometric and biochemical


World Health Organization


Authors’ contributions

SKS conceived the idea. SS and SKS designed the experiment and analyzed it, interpreted the results, and drafted the manuscript. Both authors read and approved the final manuscript.


No funding was available for this research.

Compliance with ethical standards

Competing interests

The authors declared that they have no competing interests.

Ethical approval

This analysis is based on a secondary data set with no identifiable information on the survey participants. This data set is available in the public domain for research use; hence, no approval was required from any institutional review board as there is no issue of human subject protection arising from this case.

Data availability

The data are available online on the website and can be downloaded. The International Institute for Population Sciences was the nodal agency for DLHS-4; therefore, the IIPS data center has also made the data available for public use. As the faculty and students of this institute, we accessed the data from the institute’s data center.


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Copyright information

© Springer-Verlag GmbH Germany 2017
corrected publication January/2018

Authors and Affiliations

  1. 1.Department of Mathematical Demography and StatisticsInternational Institute for Population SciencesMumbaiIndia

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