Second-hand smoke exposure prevalence among smokers versus non-smokers and relative change at sub-national level in India: a secondary analysis from Global Adult Tobacco Survey 1 and 2

Sakshi Supehia, Shivam Kapoor, Pranay Lal, Rana J. Singh, Anushikha Dhankhar


Background: Exposure to second-hand smoke (SHS) has been linked to the expanded risk of ill-effects on health every year. This study compared prevalence rates of SHS exposure between smokers and non-smokers within three different settings and states/union territories (UT) in India, during the period 2009-10 and 2016-17.

Methods: The data from two rounds of nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009-10 and 2016-17 were used. Further, the sociodemographic variables associated with exposure to SHS at different settings were analysed using multiple logistic regression analysis. All statistical inferences were based on a significance level of p<0.05.

Results: Although there was a significant decrease in overall prevalence of SHS exposure among smokers and non-smokers at home, government offices, restaurants and, public transportation and slight decrease in health care facility (p<0.05); increased level of exposure was observed at workplace which was not statistically significant (p>0.05). The prevalence of exposure to SHS varied significantly between smokers and non-smokers and differed greatly among states/UT as assessed by the relative change between GATS-1 and GATS-2. While Maharashtra, Andhra Pradesh and, Odisha were among the best-performing states; Jammu and Kashmir, Chhattisgarh and, Madhya Pradesh were the worst-performers.

Conclusions: The results confirmed that the prevalence rates of SHS exposure among non-smokers, were much higher as compared to smokers in all different settings along with state-wise disparities. This calls for the Policymakers for targeted effective enforcement of tobacco control laws, leading to a reduction in the consequences of SHS exposure.


Exposure, Global Adult Tobacco Survey, India, Second-hand smoke, Tobacco Control, Prevalence

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