TobaccoUse – NFHS-6 Data Reveals Rising Substance Use Trends Across Several States
TobaccoUse – India’s latest National Family Health Survey (NFHS-6) has highlighted a mixed picture on tobacco and alcohol consumption, showing that while national averages indicate a slight decline in tobacco use, several states are witnessing a worrying increase among women. The survey, conducted during 2023-24, also points to a rise in alcohol consumption among men, including in states where prohibition policies are in place.
Increase in Tobacco Use Among Women in Several Regions
According to NFHS-6 findings, tobacco use among women aged 15 years and above has increased in 13 states and Union Territories compared to NFHS-5 conducted during 2019-21. States such as Uttar Pradesh, Telangana and Puducherry recorded higher usage rates despite an overall national decline.
At the national level, tobacco consumption among women fell marginally from 8.9 percent to 8.4 percent. Among men, the figure declined from 38 percent to 36.3 percent. However, health experts caution that national averages often conceal regional disparities where tobacco use continues to expand.
Experts Call for Localised Tobacco Control Measures
Dr. Shalini Singh, Director of the Indian Council of Medical Research-National Institute of Cancer Prevention and Research (ICMR-NICPR), said state-level and district-level assessments are essential for designing effective interventions.
She noted that favourable national indicators should not overshadow local public health challenges. According to her, targeted strategies tailored to individual regions are necessary rather than relying solely on nationwide benchmarks.
Rural Women Show Rising Tobacco Consumption
The survey found a notable rise in tobacco use among women in several states, particularly among rural populations. Meghalaya, Nagaland, Madhya Pradesh, Uttar Pradesh, Sikkim and Chhattisgarh were among the regions that reported higher prevalence compared to the previous survey cycle.
Health specialists have expressed concern because both smoked and smokeless tobacco products remain widely available. The trend is especially significant for women of reproductive age, given the documented health risks associated with tobacco exposure during pregnancy.
Maternal and Child Health Concerns Highlighted
Medical experts warn that tobacco consumption during pregnancy can contribute to low birth weight, premature delivery and higher risks of infant mortality. Previous rounds of the family health survey also showed substantial use of smokeless tobacco among pregnant women in several central, eastern and northeastern states.
Dr. Singh stressed the need for gender-sensitive awareness campaigns, stronger regulation of smokeless tobacco products and integration of tobacco cessation services into maternal and reproductive healthcare programmes.
Tobacco Use Among Men Remains Elevated
Although national tobacco use among men has declined slightly, several states continue to report figures above the national average. Increases were observed in Arunachal Pradesh, Chhattisgarh, Madhya Pradesh, Nagaland, Punjab, Uttar Pradesh, Uttarakhand, Chandigarh and Lakshadweep, among others.
The findings indicate that tobacco remains one of the most significant preventable causes of cancer and cardiovascular disease in India, making sustained public health efforts critical.
Alcohol Consumption Shows Upward Movement
The survey also recorded a small increase in alcohol consumption among men aged 15 years and above, rising nationally from 18.7 percent to 18.9 percent. Fourteen states and Union Territories registered higher levels of alcohol use.
Among the states reporting increases were Bihar, Kerala, Uttar Pradesh, Telangana, Haryana, Chhattisgarh and Sikkim. Particularly noteworthy was the rise in Bihar, where prohibition remains in force. Similar increases were observed in other dry states such as Nagaland and Mizoram.
In contrast, Gujarat showed a decline in alcohol consumption among both men and women, making it one of the few prohibition states where survey data reflected reduced usage.
Rural Areas Face Greater Challenges
NFHS-6 data suggest that both tobacco and alcohol consumption are more prevalent in rural India than in urban areas. Experts attribute this pattern to lower health awareness, limited access to cessation services, weaker enforcement mechanisms and the affordability of products such as bidis, smokeless tobacco and locally produced alcohol.
Dr. Singh also pointed to the concentration of non-communicable disease prevention infrastructure in urban centres, leaving many rural communities with limited support.
She emphasized that frontline health workers and Ayushman Bharat Health and Wellness Centres should play a larger role in screening, counselling and cessation support. Public health experts maintain that reducing tobacco and alcohol use remains crucial in tackling India’s growing burden of cancer, cardiovascular disease and other non-communicable illnesses