A Comprehensive Analysis of Alcohol and Tobacco Use in India: Prevalence and Predictors from NFHS-5

This study provides a comprehensive analysis of alcohol and tobacco use among Indian adults using data from the National Family Health Survey-5 (NFHS-5, 2019–2021). The findings highlight substantial gender, demographic, and socioeconomic disparities in substance use patterns. Alcohol consumption was predominantly higher among men (18.3%) compared to women (4.8%), with the highest prevalence observed in the 35–49 age group for both genders. Tobacco use was even more widespread, with 28% of men and 3% of women affected. Key determinants of higher substance use included rural residence, lower educational attainment, and occupations involving manual labour. Education showed an inverse relationship with substance use; individuals with no formal education exhibited the highest prevalence, while those with higher education had significantly lower odds of consumption. Occupational disparities revealed that agricultural workers and manual labourers were most affected. Regional variations showed alcohol consumption among women was highest in South India and the Northeast, while tobacco use peaked in the Northeast. Among men, alcohol use was highest in East India, whereas tobacco use was prevalent in the Central and Northeast regions. Cultural factors, including religious and caste affiliations, also influenced consumption patterns, with Christians and Scheduled Tribes reporting higher prevalence rates. Logistic regression analysis indicated that socioeconomic factors, such as age, rural residence, and income level, were strongly associated with substance use. These findings emphasize the need for targeted public health interventions addressing the underlying demographic, socioeconomic, and cultural drivers of alcohol and tobacco use. Tailored strategies are essential to reduce the health and social impacts of these substances, particularly among vulnerable populations.