Tribal adolescents in Odisha introduced to smokeless tobacco without family control, study finds

Tribal adolescents in Odisha, home to India’s most diverse tribal communities, with the State’s 64 tribes including 13 Particularly Vulnerable Tribal Groups (PVTGs), are initiated into the consumption of smokeless tobacco as early as 12 to 16 years of age due to lack of family control, and peer pressure, a study by the regional chapter of the Indian Council of Medical Research (ICMR) has found.

The study, titled ‘A qualitative study on tobacco-use associated behaviour and major influencing factors among youths from indigenous communities of Odisha, India’, carried out by the Regional Medical Research Centre (RMRC), Bhubaneswar, an ICMR institute, and Utkal University, says the prevalence of smokeless tobacco consumption is 61% among men, and 35% among women.

The study of 210 respondents from the Santhal and Bhumij tribal communities says tobacco consumption habits are influenced by various socio-demographic determinants involving individual and community-level characteristics, including ethnicity, gender, age, education, and occupation, as well as the socio-cultural environment.

Tobacco control laws are out of step with smokeless tobacco

“We have found several factors causing the initiation of tobacco consumption. Teenagers (between the ages of 12 years to 16 years) are observed as the primary age for initiation of tobacco consumption. However, the family situation and peer group have exclusive roles to play in the initiation of the tobacco habit among adolescents and youths,” Subhendu Kumar Acharya, senior scientist at the RMRC, said.

“Early experiences due to the lack of family control were observed, leading to early habituation to tobacco. Peer pressure was also observed as the other major and crucial factor in this process, which happened through the influence of close friends and older people in the peer group,” Mr. Acharya said.

Adolescents become acquainted with tobacco at cultural spaces, including local games and festivals. Learning from elders, they explore tobacco consumption while in school or college, the study found.

“While we briefly explored institutional facilities, it was found that there are only 13 tobacco de-addiction centres in the whole of Odisha, and they are highly limited in their presence and functionality,” the RMRC scientist said, adding that the cessation of tobacco consumption is essential to reduce its associated mortality and morbidity.

“Further, lack of knowledge on the adverse health effects of tobacco use, along with this scarcity of healthcare infrastructure, are the other major factors. It needs further detailed investigation regarding the health system and associated tobacco control practices, followed by necessary intervention strategy,” Mr. Acharya said.

In an earlier RMRC study, the analysis of data on the distribution of adults using any form of tobacco in India showed Odisha as the largest consumer of any form of tobacco among both males and females in the major States in India, excluding the northeastern States.

Analysis of National Family Health Survey (NFHS)-5 data said that, as against 8.9% of national prevalence of tobacco consumption among women above the age group of 14 years, the prevalence among women in Odisha is 26%.  In the case of men, the prevalence rose to 52% compared with the national average of 38%.

The present study shows smokeless tobacco consumption among the tribes of Odisha stands at 48.4% (male 61.5%, and female 35.5%).