Association between perceived addiction and cessation behaviours among users of smokeless or combustible tobacco in India

Introduction; Addiction to tobacco is one of the main drivers of continued tobacco use. This study explored whether perceived addiction, type of tobacco and demographic characteristics were associated with past quit attempts (PQA), intention and self-efficacy to quit among combustible tobacco (CT) or smokeless tobacco (SLT) users in India. Methods: A cross-sectional survey was conducted among adult tobacco users (N = 607) attending an out-patient department in Mumbai. Logistic regression analysis was used to investigate the association between demographic characteristics, type of tobacco, addiction perceptions and cessation behaviours. Results: Being ‘a little addicted’ (adjusted odds ratio, AOR [95% confidence interval, CI] 2.75 [1.83, 4.11], P < 0.0001) or ‘quite addicted’ (AOR [95% CI] 2.93 [1.53, 5.62], P < 0.0012) was associated with lower odds of making a PQA compared to ‘not addicted at all’. Being a SLT user (AOR [95% CI] 0.64 [0.41, 0.99], P = 0.047) and female (AOR [95% CI] 0.46 [0.26, 0.81], P = 0.0068) was associated with lower odds of making a PQA. There was a significant decrease in the odds of intention to quit as age increased by 1 year (AOR [95% CI] 0.98 [0.97, 0.99], P = 0.0018). Being identified as ‘a little addicted’ (AOR [95% CI] 0.28 [0.14, 0.55], P = 0.0003), ‘quite addicted’ (AOR [95% CI] 0.16 [0.07, 0.39], P < 0.0001) or ‘very addicted’ (AOR [95% CI] 0.09 [0.04, 0.19], P < 0.0001) was associated with lower odds of self-efficacy to quit compared to ‘not addicted at all’. Discussion and Conclusion: Lack of awareness about addiction may inhibit cessation, particularly among less educated and female users of SLT and CT products.