A qualitative study on tobacco- use associated behavior and major influencing factors among youths from indigenous communities of Odisha, India

Tobacco use is a significant public health concern globally. In India, tobacco-related behaviors are increasing in a worrying pattern and such burden is highly prevalent among tribal and indigenous populations. This present study, conducted in Odisha, the state with the highest number of tribal communities in India, examines the factors that explain tobacco use behavior, its initiation, and continuation among two of the largest tribes in Odisha: the Santal and Bhumij communities. An exploratory cross-sectional qualitative study was conducted using ethnographic approaches such as in-depth interviews and participant observation among individuals from Santal and Bhumij indigenous communities aged 10 years and older and up to 30 years. A total of 13 in-depth interviews were conducted and used for the final analysis for this study. Findings of the present study indicates excitement to experience, family influences, and lack of family control were key factors influencing the initiation of tobacco among children and youths. Peer pressure was observed of playing a significant role among the young adults. Individual perceptions and affordability were reasons for continuing with local tobacco products like bidi, Dukuta, Khaini. Cultural practices and festivals occasions were found to be major circumstances for tobacco use initiation and heavy consumption. The present research highlights the tobacco use associated with major social and cultural factors by discussing the scope for tobacco control among tribal youths of two major tribes in India. The findings also indicate the high scope for developing tobacco control-associated implementation design and tobacco control interventions in these indigenous communities.