Determinants of tobacco use patterns and predictors of quit among older women in India: Findings from the study on global aging and adult health

INTRODUCTION Despite low prevalence of tobacco smoking among women in India, smokeless tobacco (SLT) use constitutes a significantly higher burden. There is limited previous research in the field of tobacco use and quitting behavior particularly in older women in India. The study aims to ascertain the prevalence, patterns, and sociodemographic determinants of tobacco use and predictors of quit among older women in India. METHODS Cross-sectional and nationally representative data from the first and second wave of WHO's Study on global Ageing and Adult Health (SAGE 2007 and 2015) were analyzed. Outcome variables included smoking and SLT use, with quit status assessed, while explanatory variables encompassed sociodemographic characteristics like age, education level, marital status, body mass index, religion, ethnicity, residence, wealth quintiles, and mother tongue. RESULTS We observed a reduction in the prevalence of tobacco use in any form among women from 34.17% (SAGE-1) to 18.17% (SAGE-2). The prevalence of current tobacco use in any form was 9.89% (n=352; 95% CI: 8.74-11.17), tobacco smoking was 9.42% (n=331; 95% CI: 8.29-10.69), while the prevalence of current SLT use was 12.3% (n=454; 95% CI: 10.99- 13.72). Muslim women had significantly higher odds of using SLT compared to Hindu women (AOR=1.86; 95% CI: 1.24-2.69). Successful quit after initiation to SLT use was reported in only 7.62% of the women. Women from scheduled caste ethnicity were less likely to achieve a successful quit (AOR=0.70; 95% CI: 0.09-5.81) compared to other caste groups. CONCLUSIONS Approximately one in five older women used tobacco, with higher prevalence than GATS data, underscoring the need for continued surveillance and focused public health efforts. Furthermore, quit rates in female SLT users continue to be very low suggesting the need for strengthening access, availability, and affordability of tobacco cessation services to promote successful quitting behavior.