Determinants of tobacco use and perception, attitude about an antitobacco act in rural Haryana, North India

Background: Tobacco use is one of the most important preventable causes of morbidity and mortality in India. It is essential to study perception, practices and factors determining tobacco use to formulate the intervention for addressing this problem in the community. Materials and Methods: A cross-sectional study was carried out in 28 villages in Ballabgarh block of Faridabad, Haryana. This study aimed to understand factors determining tobacco use and to assess knowledge, attitude, practices about tobacco use and antitobacco act. Systematic random sampling was done to select study subjects. Total calculated sample size was 880. One eligible male and one female were selected randomly from household. Knowledge was assessed using semi-structured interview schedule while attitude using five-point likert scale. In addition, focus group discussions and in-depth interviews were conducted among various stakeholders and opinion leaders to get insight about practices and factors determining tobacco use in the community. Results: Total 892 subjects were enrolled in the study, of which 51% were male. The mean age of the study subjects was 49.5 years (standard deviation: 17.5). Though awareness about harmful effects of tobacco use was reported, awareness about legislations under an antitobacco act was poor. Early initiation and continued use of all forms of tobacco were reported. Prevalent practice of tobacco use was attributed to pressure from peer groups, social customs and lack of de-addiction services at the community level by study subjects. Conclusion: Tobacco use in this rural community was mainly attributed to social and cultural factors. A multi-pronged public health approach is needed for addressing this complex problem the community.