Prevalence and Correlates of Hardcore Smoking in India

Abstract

Hardcore smoking refers to inability or unwillingness of regular smokers to quit. Daily smoking, no past quit attempt and no future quit intention, nicotine dependence, etc., are used to define hardcore smoking. Continued use, nicotine dependence and recalcitrant to interventions makes hardcore smoker more prone to tobacco-induced diseases. However, despite multiple estimates of smoking prevalence in India, there is little information on hardcore smoking epidemiology, which has bearing on smoking cessation planning. This study is aimed at quantifying the prevalence and associated factors of hardcore smoking in India. This study used the data generated by GATS-India survey. Hardcore smoking was ascertained when following five criteria were met, i.e., (1) current daily smoking, (2) nil quit attempt in the past 12 months of survey or last quit attempt of less than 24 h duration, (3) no intention to quit in the next 12 months or not interested in quitting, (4) time to first smoke within 30 min, and (5) knowledge of smoking causing serious illness. The number of hardcore smokers among adult Indians is estimated to be 24.3 million (3.1%). The logistic regression model suggests that typical Indian hardcore smokers are older males having occupation other than self-employment. The huge number (24.3 million) of hardcore smokers is a real threat to tobacco control interventions in India and suggests urgent need for a universal tobacco-cessation program. Our study results also emphasize need for standard definitions of hardcore smoking