Abstract
Objectives
We describe national and subnational trends in tobacco use over three decades in India, assess the impact of the World Health Organization’s Framework Convention on Tobacco Control (FCTC) on them and draw inferences for regional tobacco control policy.
Methods
Data from nine cross-sectional surveys conducted between 1987 and 2016 were analysed. Time trends in gender- and state-wise prevalence were derived for different forms of tobacco. To assess Framework Convention’s impact, relative changes in tobacco prevalence before and after its implementation were estimated. Progress towards global noncommunicable diseases target was also measured.
Results
Post-implementation of the FCTC, smoking and smokeless tobacco use declined by 52.9% and 17.6%, respectively. The tobacco product mix (exclusive smokeless/exclusive smoked/dual) underwent a reversal from 37:52:11 in 1987 to 65:22:13 in 2016. Having achieved 20.5% relative reduction since 2009, India is en route to achieving the global noncommunicable diseases target.
Conclusions
Steep declines in tobacco use have followed the implementation of FCTC in India. However, the impact has been unequal on smokeless and smoked forms. Tobacco-control policies in high smokeless burden countries should take cognizance of this pattern and design comprehensive and flexible policies.
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RSA conceived the study and managed the overall enterprise; DNS and PCG identified and extracted the data sources; NA carried out data management; RSA, KJ, RSR and DV performed the analysis; DNS, PCG, NA and SK provided critical feedback on the analysis, results and interpretation; KJ, RSR and RSA wrote the first draft. All authors approved the final manuscript.
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This article does not contain any studies with human participants or animals performed by any of the authors. The original surveys included in the analysis had obtained ethical approvals from the participating institution’s boards. The data sets of these surveys were publicly available or available on request, and all individual identifying information was removed.
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Suliankatchi Abdulkader, R., Sinha, D.N., Jeyashree, K. et al. Trends in tobacco consumption in India 1987–2016: impact of the World Health Organization Framework Convention on Tobacco Control. Int J Public Health 64, 841–851 (2019). https://doi.org/10.1007/s00038-019-01252-x
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DOI: https://doi.org/10.1007/s00038-019-01252-x