Socio-Demographic Determinants and Behavioral Triggers of Tobacco Use: Insights From a Retrospective Study in Pune, India

Background Tobacco use remains a major public health concern in India, with significant health, social, and economic consequences. Understanding patterns of use and behavioral triggers in clinical populations is essential for designing targeted cessation strategies. Objective To describe patterns of tobacco use, behavioural triggers, and nicotine dependence among patients attending a Tobacco Cessation Center (TCC) in Pune, India. Methods A retrospective descriptive analysis was conducted using anonymized intake records of 5,403 patients attending a TCC at a dental hospital between June 2017 and June 2023. Data on age, sex, marital status, occupation, type of tobacco use, behavioral triggers, nicotine dependence (assessed using the Fagerström test for nicotine dependence and its modified version for smokeless tobacco), quit attempts, and monthly expenditure were extracted. Descriptive statistics were used to summarize the data. Results The majority of participants were male (76.6%), married (85.2%), and belonged to the 41-60 years age group (42.1%). Smokeless tobacco was the most commonly used form of tobacco (71.9%), followed by smoking (27.0%), while dual use was reported by 1.1% of participants. Craving was the most frequently reported behavioral trigger for tobacco use (73.5%), followed by stress (17.7%) and peer influence (5.2%). Skilled professionals (39.2%) and unemployed individuals (32.3%) constitute the major occupational groups. Moderate nicotine dependence was the most commonly observed category (50.4%), followed by low dependence (33.8%) and high dependence (15.8%). Conclusion Tobacco use in this clinical population was predominantly observed among middle-aged males, with craving and stress reported as common triggers. The findings highlight the need for targeted, context-specific tobacco cessation strategies focusing on behavioral support and nicotine dependence management. However, given the descriptive design, no causal inferences can be made.