Sex Disparities in Smoked and Smokeless Tobacco Use Among Displaced Populations in Mizoram, India: A Cross-Sectional Study

Displaced populations face an elevated risk for tobacco use, especially smokeless tobacco (SLT), due to its affordability and acceptability in regions like Mizoram State (India) and Chin State (Myanmar). Despite this, limited research exists on tobacco use patterns and contributing factors among displaced populations. This study aimed to examine smoked tobacco and SLT use among displaced communities in Mizoram, India. We collected data across nine villages using mobile health technology. We conducted logistic regression models to examine the cross-sectional associations between sex and tobacco use. Age was explored as a potential moderator. The analytic sample consisted of 2226 participants, with a mean age of 43 (±16.2) years, 63.1% of whom were women. Approximately 70% of the participants reported using tobacco, with SLT being the most common form (46.3%). Women were 57% less likely to use tobacco than men, but women aged 55 and older had twice the odds of using tobacco compared to men in the same age group. Additionally, women had nearly 71 times higher odds of using SLT compared to smoked tobacco than men. The findings underscore the need for culturally sensitive interventions targeting SLT use among women. Future research should explore the drivers of this disparity to guide public health strategies.