Poverty does not limit tobacco consumption among tribal populations: evidence from Central India.

Globally, the prevalence of adult smoking is more than 1.1 billion; among them 82% residing in low and middle income countries (Jha et al., 2002). Tobacco use is a cause for many diseases like cancer, tuberculosis, heart disease, and it continues to be the leading cause of preventable deaths (International Union Against Tuberculosis and Lung Disease, 2012). It kills nearly 6 million people and causes hundreds of billions of dollars of economic damage worldwide. If current trend continues, by 2030 tobacco will kill >8 million people worldwide each year, with 80% of these premature deaths among people living in low and middle income countries (World Health Organisation, 2011). It is reported that 1/5 male deaths and 1/20 female deaths over the age of 30 years is due to tobacco use (Jha et al., 2002). About half of them are in reproductive and economically active segment of the population. The Regional Medical Research Centre for Tribals, Jabalpur, Madhya Pradesh (MP) has undertaken a series of studies to estimate the magnitude of tribal health problems and to suggest control measures to improve health condition of tribal population health. Part of our tribal health research activities we performed this study to estimate the prevalence of tobacco use among the tribal population of Kundam Block and the salient findings have been seen, including: Living standards: Of 1021 households were interviewed, 96% (981) lived in kachha houses made of mud, thatched or other low quality materials. Among them 33% were living in single room, 23% did not have separate kitchen, 12% did not have electric power in there house, 78% reported main source of water as hand pump and 96% used open defication as a toilet facility. Socio-economic profile: Among females only one percent were house wives, others were engaged in agriculture either as a farmer, agriculture labour or as other labour works. The level of education shows that 41% were illiterates and only one percent was graduated. Prevalence of tobacco use: It was observed that 2970 (65%) consumed some form of tobacco and prevalence of tobacco use in different socio-economic group was given in Figure-1. Around 47% (men 34%, women 59%; p<0.05) chewed tobacco/pan masala; 15% (men 28%, women 2%; p<0.05) smoked tobacco and 3% (men 6%, <1% women) both smoked and chewed tobacco. The prevalence of chewing tobacco was significantly higher in all age groups as against smoking. It was also observed that children in the age of 6-9 years started using tobacco LETTER to the EDITOR