Trends and correlates of hardcore smoking in India: findings from the Global Adult Tobacco Surveys 1 & 2

Background: Data on prevalence of hardcore smoking (HCS) among different socioeconomic status (SES) groups in low- and middle-income countries are limited. We looked at the pattern HCS India with following objectives: 1) to analyse association between SES HCS, 2) find trends 3) state-wide variations smoking. Methods: individuals aged ≥25 years from Global Adult Tobacco Survey (GATS) 2009-10 (N= 9223) 2016-17 7647) were used for this study. If an individual met all criteria: (1) current smoker, (2) smokes 10 or more cigarettes/day, (3) first puff within 30 minutes after waking up, (4) no quit attempt last 12 months, (5) intention next (6) lack knowledge harmful effect smoking, s/he was identified as a smoker. Multiple regression analysis done factors associated HCS. Results: Prevalence deceased 2.5% GATS 1 1.9% 2: males 6.2% 3.9% females 0.3% 0.2%. Compared richest group poorest, poor those who belonged likely report 2. However, only poorest there increase proportion smokers 2 compared 1. Other that significantly both surveys male gender, working adults, lower education, early initiation households without any rules inside home. Conclusions: control cessation efforts need focus particularly high Indian states.