Tobacco and Alcohol Associated Mortality among Men by Socio-Economic Status in India

Mangesh S. Pednekar*, Jooi Vasa, Sameer S. Narake, Dhirendra N. Sinha and Prakash C. Gupta

Tobacco and Alcohol Associated Mortality among Men by Socio-Economic Status in India.

Globally, tobacco kills approximately 6 million people and causes more than a trillion dollars of economic damage each year. Similarly, the use of alcohol kills approximately 2.3 million people each year. More than half of these deaths occur from NCDs (Non-communicable disease) including cancer, cardiovascular disease, and liver cirrhosis. Nearly, 80% of NCD deaths occur in low-and-middle-income countries. Tobacco consumption and alcohol use together accounts for about 18% of global deaths. In addition to communicable diseases, NCDs are becoming major threat in India for increasing the burden of diseases. Age standardized NCD death rates ranges from 571 among women to 782 among men.

In addition to cigarette smoking the varying forms of tobacco and alcohol practices prevalent in India contribute to increasing the disease burden. The mortality patterns may also vary by Socioeconomic status (SES). The common observed association between SES and health outcomes has been of a strong inverse relationship with those in lower SES groups having higher mortality.5-9 Thus, examining tobacco and/or alcohol associated mortality by SES may delineate the health
disparities that may further help to address the disparities.

Using the Mumbai cohort study, we had previously reported tobacco as an independent risk factor for deaths from NCDs and communicable diseases. These earlier results on tobacco associated mortality, based on follow-up of 99,570 men and women (age=>35 year), showed higher Hazard Ratios (HRs) for bidi, cigarette smokers, and smokeless tobacco (SLT) users compared to never-users. In this paper, we present the joint effect of tobacco (SLT use, bidi, cigarette smoking) and alcohol use on all-causes mortality stratified by SES.

Epidemiol Open J
. 2016; 1(1): 2-15. doi: 10.17140/EPOJ-1-102