Awareness and Attitude Towards Tobacco Products and Tobacco Industry and Perception about Government’s Role in Tobacco Control among the Adult Rural Population: A Cross-sectional Study in the Indian State of Bihar

Document Type : Original Article


1 Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, India

2 Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India

3 Department of Community Medicine, NAMO Medical Education and Research Institute, Silvassa, India

4 Dr. RML Institute of Medical Sciences, Lucknow, India



Background: Attitudes and impressions toward the tobacco industry and tobacco products among the general public are important 
determinants for curbing the menace of the tobacco epidemic. Accordingly, this study aimed to assess the knowledge and perceptions 
about the tobacco industry and tobacco products and analyze attitudes towards social denormalization (SD) of tobacco use and 
tobacco industry denormalization (TID) among the rural population of Bihar, India.
Methods: This community-based cross-sectional survey was conducted on 421 adults aged 18 to 65 years who were selected using 
multistage systematic random sampling in a rural area of Bihar State in India from January to March 2022. Results were presented 
as proportions and the factors associated with support for TID and SD were identified using the chi-square test and binary logistic 
Findings: Out of 421 participants, 342 (81.2%) did not consider smokeless tobacco to be very dangerous. Nearly half (192, 45.6%) 
of the individuals believed that tobacco companies never tell the truth about the ill effects of tobacco use on health. Maximum, 
345 (89.5%) also believed that the tobacco industry is responsible for adverse health effects of tobacco use and that the government 
should sue them. The prevalence of favorable attitudes toward TID and SD was found to be 55.1% [95% CI: 50.3% – 59.8%] and 
38.2% [95% CI: 33.7% – 42.9%], respectively.
Conclusion: One out of every two and one out of every three individuals showed favorable attitudes toward TID and SD, respectively. 
There is a need to inform and educate the public on the ill effects of tobacco and the deceptive strategies used by the tobacco
industry to help them choose health over tobacco.


Bijaya Nanda Naik: (Google Scholar) (PubMed)

Rajath Rao: (Google Scholar) (PubMed)

Manisha Verma: (Google Scholar) (PubMed)

Santosh Kumar Nirala: (Google Scholar) (PubMed)

Sanjay Pandey: (Google Scholar) (PubMed)

Chandramani Singh: (Google Scholar) (PubMed)


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