Assessment of Nicotine Dependence and its Determinants Among Tobacco Users in Rural Community of Tamil Nadu

Abstract Introduction: As a major cause of disease and mortality, tobacco smoking continues to be a major global public health concern. However, there is a limited understanding of the specific determinants of nicotine dependence in rural settings like Tamil Nadu. The purpose of this study is to determine the prevalence of nicotine dependency among tobacco users and investigate its contributing factors to develop evidence-based approaches to dealing with this widespread problem. Methodology: A community-based cross-sectional study was conducted from October 2023 to July 2024 among tobacco users aged 18 years and above residing in a rural area of Chengalpattu district, Tamil Nadu. A sample size of 338 was collected using a multistage sampling technique. A prevalidated, semistructured interview schedule was used for data collection. The inferential statistics were conducted using the Pearson Chi-square test and bivariate logistic regression analysis, with P < 0.05 considered significant. Results: The study (n = 338) found that 73 (21.6%) of participants had high physical dependence, while 185 (54.7%) showed moderate levels, 72 (21.3%) had low to moderate dependence, and 8 (2.4%) had low dependence. In terms of psychological dependence, 25 (7.4%) of users reported no dependence, 117 (34.6%) mild, 160 (47.3%) moderate, and 36 (10.7%) severe. Several factors were significantly associated with nicotine dependence, including age over 40 years, being male, marital status, living in a nuclear family, early onset of tobacco use, prolonged duration of use, frequent consumption, concurrent alcohol intake, and existing health conditions ( P < 0.05). Conclusion: Understanding these determinants is crucial for developing targeted interventions such as integrating cessation counselling into primary health centers. Strengthening awareness campaigns and providing accessible support systems can help mitigate the impact of tobacco dependence in rural populations.