Prevalence and determinants of nicotine dependence among adult tobacco users residing in the Coastal Areas of the Chengalpattu District, Tamil Nadu, India: A cross-sectional study

ABSTRACT Background: Tobacco consumption is a leading preventable cause of morbidity and mortality worldwide. Coastal populations are particularly vulnerable due to cultural practices, occupational stress, and easy access to both smoking and smokeless tobacco products. Limited evidence exists regarding the prevalence and determinants of nicotine dependence due to tobacco usage in coastal areas of Tamil Nadu, India. Objective: This study aimed to estimate the prevalence and determinants of nicotine dependence among adult tobacco users residing in coastal areas of Chengalpattu District, Tamil Nadu. Materials and Methods: A community-based cross-sectional study was conducted among adults (≥18 years) residing in selected coastal villages of Chengalpattu District. Using multistage random sampling, 400 participants were enrolled in this study. A pre-tested, semi-structured questionnaire was used to collect sociodemographic details, tobacco use history, and associated risk factors. Nicotine dependence was assessed using the Fagerström Test for Nicotine Dependence (FTND) for smokers and the Fagerström Test for Nicotine Dependence—Smokeless Tobacco for smokeless tobacco users. Data were analyzed using the Statistical Package for the Social Sciences version 23. Logistic regression was performed on various determinants associated with nicotine dependence. Results: On multivariate analysis, male gender, illiteracy, long working hours, smokeless tobacco, and duration of tobacco use were significantly associated with nicotine dependence ( P <0.05). Conclusion: The high prevalence of nicotine dependence in the coastal areas of Chengalpattu District may reflect occupational stress and cultural acceptance of smokeless tobacco among fishing and manual labor communities. Focused cessation campaigns addressing occupational triggers and social norms could improve intervention outcomes.