Slum and non-slum differences in tobacco and alcohol use among the adult population: a sex-stratified study from eight megacities of India

Background: Evidence on the prevalence and determinants of smoking and smokeless tobacco (SLT), and alcohol consumption between slums and non-slums are quite limited. Methods: Using sub-samples from the National Family Health Survey (2015-16), prevalence and determinants of tobacco and alcohol use were estimated in eight Indian megacities (Chennai, Delhi, Hyderabad, Indore, Kolkata, Meerut, Mumbai, and Nagpur) by residence and sex using binary logistic regression analyses. Inter-and intra-city differences in both forms of tobacco and alcohol by residence were assessed using interaction effect analysis. Results: Strong intra-urban disparity in tobacco and alcohol use was observed. Both forms of tobacco use were higher among men and women residing in slum areas. Despite alcohol use being higher among men from non-slum areas (33.1%) compared to those from slum areas (27.7%), the likelihood of alcohol use was higher among men residing in slums (OR = 1.37;95%CI:1.06-1.77). Higher odds of SLT use were observed among men and women from slums than in non-slum areas. Both forms of tobacco use were higher in slums from North, East, and West Indian cities, whereas alcohol use was higher among males from East and South Indian cities. Conclusions: Continuous monitoring of tobacco and alcohol use in slums is warranted to achieve Sustainable Development Goals.