Smokeless tobacco use, its sociodemographic and clinical correlates among tribal populations of Odisha, India

Smokeless tobacco (SLT) use remains a major public health concern for tribal communities in Odisha, India. This study aimed to identify sociodemographic factors associated with SLT use and examine its association with selected clinical biomarkers. A population-based cross-sectional study was conducted across 14 tribal districts of Odisha between July 2022 and July 2023, including 20,956 individuals aged 10–59 years. Overall, 30.3% of participants reported current SLT use. Khaini was the most commonly used SLT product (69.9%), followed by gutkha (23.8%). SLT use is highly prevalent (30.3%) among tribal populations in Odisha and is clustered among males, older adults, individuals with lower education and wealth, the employed, and alcohol users. In adjusted analyses, SLT use was independently associated with higher systolic blood pressure (aPR per 1 mmHg: 1.005; 95% CI 1.001–1.009) and elevated SGOTD (aPR per 1 U/L: 1.005; 95% CI 1.001–1.009), although the effect sizes were modest. Given the high prevalence of SLT use and limited cessation services, these findings highlight the need for targeted public health interventions in tribal communities.