Tobacco use among adults in India, healthcare provider advice and quit attempts: analysis of NFHS-5

Background: Tobacco use is a leading preventable cause of morbidity and mortality in India and contributes substantially to cancers and other non-communicable diseases. Both smoked and smokeless tobacco products are widely used. Advice from healthcare providers is a proven, cost-effective intervention to promote tobacco cessation, yet its coverage and impact at the population level remain suboptimal. This study assessed patterns of tobacco use, receipt of healthcare provider advice to quit, and quit attempts among adults in India. Methods: This was a cross-sectional secondary data analysis using the National Family Health Survey-5 (NFHS-5), conducted during 2019-21. The analysis included men and women aged 15 years and above. Current tobacco use (smoked and/or smokeless), receipt of advice to quit tobacco from a healthcare provider in the past 12 months, and self-reported quit attempts were examined. Descriptive statistics were used to estimate prevalence, and associations with socio-demographic characteristics were assessed. Results: A considerable proportion of adults reported current tobacco use, with smokeless tobacco use being more prevalent than smoked forms. Among current tobacco users, only a small proportion reported receiving advice to quit from a healthcare provider. Quit attempts were more frequent among individuals who had received professional advice compared to those who had not. Significant variations were observed in tobacco use, receipt of advice, and quit attempts across age groups, sex, education levels, place of residence, and wealth quintiles. Conclusions: Tobacco use remains highly prevalent in India, while the delivery of healthcare provider-initiated cessation advice is inadequate. Expanding routine tobacco cessation counselling within healthcare settings, particularly at the primary care level, could enhance quit attempts and reduce the long-term burden of tobacco-related diseases.