Data Bytes

The majority of tobacco use in India is of chewing tobacco products such as paan masala, gutkha, or khaini. Gutkha is pre-mixed paan masala with tobacco. Paan masala is also sold separately and mixed with tobacco later to be consumed.

Since most tobacco consumption in India is by men, we look at the type of tobacco usage by men. About 40% of men aged 15-49 use tobacco in some form, compared to just 5% of women, according to the National Family Health Survey, 2021.

Tobacco use in India as measured by the NFHS includes smoking cigarettes or bidis, as well as chewing tobacco products such as khaini (tobacco leaves mixed with slaked lime), paan masala, gutkha, and other similar preparations. Since respondents may use tobacco in more than one form, the NFHS does not measure consumption of these products as discrete categories.

More than a quarter of men chew tobacco products, while under one in five men smoke bidis or cigarettes. Tobacco usage is higher in rural areas, and the form of usage also differs, with cigarette smoking more prevalent among urban men.

Both forms of tobacco have major health impacts, including life threatening conditions like cancer of the oral cavity, oesophagus and liver, as well as heart diseases and respiratory illnesses.

Read more about the most common diseases in India.

The usage of tobacco varies by region in India and is highest in its eastern states and lowest in the southern states and in Punjab.

Almost four in ten men aged 15-49 use tobacco in some form, according to the National Family Health Survey (2019-21). Given that fewer than one in ten women use tobacco, we look at data for men to understand regional patterns in tobacco consumption.

Tobacco use is highest in India's north-eastern states, where more than half the male population uses tobacco or tobacco products. Several eastern states, including Odisha and Bihar, also report very high tobacco use among men at over 50%, followed by Jharkhand and West Bengal.

In contrast, many states in the south, as well as Punjab, have much lower levels of tobacco consumption.

The type of tobacco consumed also varies widely across states. In western and central India, most men who use tobacco consume chewing products such as gutkha, paan masala and khaini. In the southern and northern states, where overall tobacco use is lower, smoking bidis or cigarettes is more common among those who do consume tobacco. In the north-eastern states, patterns differ by state, with chewing tobacco more common in Assam, Arunachal Pradesh and Manipur, while smoking is more prevalent in Meghalaya and Mizoram.

All forms of tobacco have serious health consequences and are a major risk factor for serious non-communicable diseases, like cancers, heart disease and respiratory illnesses.

Read more about the rise of non-communicable diseases in India.