Tobacco Use Pattern, Dependence, Oral Cancer Awareness and Health Education needs Among Urban Slum Dwellers of Jodhpur City

Vibha Joshi, Nitin Kumar Joshi, Komal Bajaj


Background: The rapid migration from rural to urban region results in mushrooming of slums in India. Urban‑slums are comparatively poor vulnerable groups which are mostly affected with oral cancer due to higher exposure to risk factors like tobacco use. Aims: To assess pattern of tobacco consumption, awareness about oral cancer and related health education needs in urban slums of Jodhpur city.

Methods: Study was conducted during July 2018Nov 2018 in slum of Jodhpur city. On the basis of cluster sampling strategy data were collected from 1200 participants regarding tobacco use and perception regarding oral cancer to identify health education needs in urban slums. Descriptive statistics, Chi‑square test, multivariate logistics analysis were used and P < 0.05 was considered statistically significant.

Results: A total of 1200 participants were surveyed, out of which 48.5% were males. Among the study population, 58.5% (n = 462/789) males and 41.45% (n = 327/789) females were consuming tobacco in one or more forms. The statistical association between: age and bidi, gutka, zarda consumption; gender and bidi, cigarette, gutka consumption was found to be significant (P < 0.001). The younger population (1530 years) has more willingness to quit tobacco than the older population. (OR = 1.52, 95% CI = 1.092.11). Almost 56% were aware of oral cancer.

Conclusions: An effective information, education and communication (IEC) strategy for tobacco cessation should be designed with focus on different education needs according to age, gender, and education status of slum population.


Mouth neoplasm; need assessment; poverty areas; tobacco use

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Tobacco [Internet]. 2020. Available from: https://www.‑room/fact‑sheets/detail/tobacco. [Last cited on

Jul 15].

Heart disease and stroke are the commonest ways by which

tobacco kills people [Internet]. 2018. Available


wntd_2018_india_fs.pdf; sequence=1. [Last cited on 2019

Aug 02].

Madani AH, Dikshit M, Bhaduri D. Risk for oral cancer

associated to smoking, smokeless and oral dip products. Indian J

Public Health 2012;56:57‑60.

Thakur JS, Garg R, Narain JP, Menabde N. Tobacco use:

A major risk factor for non communicable diseases in South‑East

Asia region. Indian J Public Health 2011;55:155‑60.

McKay AJ, Patel RKK, Majeed A. Strategies for

tobacco control in India: A systematic review. PLoS One


Tata Institute of Social Sciences (TISS), Mumbai and Ministry of

Health and Family Welfare, Government of India. Global Adult

Tobacco Survey GATS 2 India 2016‑17.

Mehta T, Shah S, Dave B, Shah R, Dave R. Socioeconomic and

cultural impact of tobacco in India. J Family Med Prim Care


Allender S, Lacey B, Webster P, Rayner M, Deepa M,

Scarborough P, et al. Level of urbanization and

non‑communicable disease risk factors in Tamil Nadu, India.

Bull World Health Organ 2009;88:297‑304.

World Health Organization, Regional Office for South‑East

Asia. Addressing health of the urban poor in South‑East Asia

Region: Challenges and opportunities. WHO Regional Office for

South‑East Asia; 2011.

Banerjee A, Bhawalkar JS, Jadhav SL, Rathod H, Khedkar DT.

Access to health services among slum dwellers in an industrial

township and surrounding rural areas: A rapid epidemiological

assessment. J Family Med Prim Care 2012;1:20‑6.

Sharma S, Satyanarayana L, Asthana S, Shivalingesh KK,

Goutham BS, Ramachandra S. Oral cancer statistics in India on

the basis of first report of 29 population‑based cancer registries.

J Oral Maxillofac Pathol 2018;22:18‑26.

Rooban T, Rao U, Joshua E, Ranganathan K. Prevalence and

correlates of tobacco use among urban adult men in India:

A comparison of slum dwellers vs non‑slum dwellers. Indian J

Dent Res 2012;23:31.

GATS‑2 Globally adult tobacco survey factsheet India

‑2017 [Internet]. 2020. Available from: https://

India_2016‑17_FactSheet.pdf. [Last cited on 2020 Feb 07].

Nair S, Schensul J, Begum S, Pednekar M, Oncken C, Bilgi S,

et al. Use of smokeless tobacco by Indian women aged

–40 years during pregnancy and reproductive years. PLoS One


Gupta S, Sharma A, Agrawal S, Gupta S, Sarouthia S. A health

education intervention study on tobacco consumption among

the urban slum residents of central India. Int J Prev Med


Sankhla B, Kachhwaha K, Hussain SY, Saxena, S, Sireesha SK,

Bhargava A. Genotoxic and carcinogenic effect of Gutkha:

A fast‑growing smokeless tobacco. Addict Health 2018;10:52‑63.

Kyaing NN, Islam MA, Sinha DN, Rinchen S. Social, economic

and legal dimensions of tobacco and its control in South‑East

Asia region. Indian J Public Health 2011;55:161‑8.

Mishra GA, Kulkarni SV, Gupta SD, Shastri SS. Smokeless

tobacco use in Urban Indian women: Prevalence and predictors.

Indian J Med Paediatr Oncol 2015;36:176‑82.

Srivastava M, Parakh P, Srivastava M. Predictors and prevalence

of nicotine use in females: A village‑based community study. Ind

Psychiatry J 2010;19:125‑9.

Garg A, Chaturvedi P, Mishra A, Datta S. A review on harmful

effects of pan masala. Indian J Cancer 2015;52:663‑6.

Srivastava R, Jyoti B, Pradhan D, Siddiqui Z. Prevalence of oral

submucous fibrosis in patients visiting dental OPD of a dental

college in Kanpur: A demographic study. J Family Med Prim

Care 2019;8:2612‑7.

Ray C, Gupta P. Areca nut use and cancer in India. Biomed Res

J 2015;2:140.

Gupta VK, Malhotra S. Display of health‑risk warning on

“arecanut sachets”. Indian J Cancer 2015;52:138.

Biederman J, Monuteaux MC, Mick E, Wilens TE,

Fontanella JA, Poetzl KM, et al. Is cigarette smoking a gateway

to alcohol and illicit drug use disorders? A study of youths

with and without attention deficit hyperactivity disorder. Biol

Psychiatry 2006;59:258‑64.

Drobes JD. Concurrent alcohol and tobacco dependence

mechanisms and treatment. Alcohol Res Health 2002;23:136-42.

Agrawal M, Pandey S, Jain S, Maitin S. Oral cancer awareness

of the general public in Gorakhpur City, India. Asian Pac J

Cancer Prev 2012;13:5195‑9.

Shimpi N, Jethwani M, Bharatkumar A, Chyou PH, Glurich I,

Acharya A. Patient awareness/knowledge towards oral cancer:

A cross‑sectional survey. BMC Oral Health 2018;18:86.

Thatcher DL, Clark DB. Adolescents at risk for substance use

disorders: Role of psychological dysregulation, endophenotypes,

and environmental influences. Alcohol Res Health


Manual for Tobacco Cessation. Directorate General of Health

Services, Ministry of Health and Family Welfare, Government of

India. 2005.

Cruz TB, Rose SW, Lienemann BA, Byron MJ, Meissner HI,

Baezconde‑Garbanati L, et al. Pro‑tobacco marketing and

anti‑tobacco campaigns aimed at vulnerable populations:

A review of the literature. Tob Induc Dis 2019;17:68.