Tobacco Survey (TNTS) 2015 - 2016 FACT SHEET Tamil Nadu Tobacco Survey (TNTS) 2015 - 2016 FACT SHEET TAMIL NADU TOBACCO SURVEY (TNTS) 2015-2016 CONTRIBUTORS FACT SHEET Tobacco use in Tamil Nadu Organizations involved in TNTS field work Tobacco Use by Age, Gender and Residence (Percentage of adults age 15 and above) Organizations Districts Organizations Districts Annamalai University Cuddalore Sethu Institute of Technology Virudhunagar Tamil Nadu Tobacco users Non - tobacco users Vellore Barathiyar University Shanthi Seva Trust Dindigul Kanchipuram Arts and Science College The Nilgiris Krishnagiri Sree Renga Hospital Kancheepuram Tiruvannamalai Age Bharathidasan University Constituent College Nagapattinam and Tiruvarur Tagore Institute of Engineering Dharmapuri and Technology Salem 1.4 98.6 15 - 24 Tiruvallur Viluppuram Cancer Institute (WIA) Ariyalur, Krishnagiri, Perambalur Tirumagal Mills Salem Theni and Tiruppur 24 - 44 5.0 95.0 Government Arts College Vellore Chennai Erode Cuddalore Nilgiris Government Arts College Karur Namakkal Ultra’s Best Dental College Madurai Vellore 7.9 92.1 Perambalur 45 - 64 Ariyalur Nagapattinam Government Arts College Ramanathapuram and Sivagangai Venkateshwara Arts and Coimbatore Tiruchirappalli Tirupur Karur Kanchipuram 8.1 91.9 Rajah Serfoji Government College Thanjavur Science College Dharmapuri 65 + Thanjavur Krishnagiri Tiruvarur Tiruvannamalai Government Arts College Tiruvannamalai Coimbatore Cancer Dindigul Gender Pudukkottai Foundation (CCF) in Arignar Anna Government association with Department 8.6 91.4 Arts College Villupuram Male Madurai Sivaganga of Social work, PSG College of Theni Dharmapuri Jamal Mohammed College Arts and Science Coimbatore Female 1.9 98.1 of Arts and Science Trichy Viluppuram Virudhunagar

Ramanathapuram K.S.Rangasamy College of Chennai Residence Technology, Namakkal Salem Tuticorin Cancer Institute (WIA) , , Cuddalore 4.9 95.1 Tirunelveli Manonmaniam Sundaranar Erode Urban , Manali, Nilgiris Percentage University Tirunelveli , , TAMIL NADU 5.6 94.4 < 5.0 Royapuram, Namakkal Rural Kanyakumari Mary Anne Charitable Perambalur Thiru-Vi-Ka Nagar, 5.1 - 10.0 Trust (MACT) Pudhukottai Ariyalur Nagapattinam Percentage and . 10.1 and above National Engineering College Tuticorin Coimbatore Tiruchirappalli Mary Anne Charitable Tirupur Karur Nazareth College of Arts Trust Thanjavur and Science Thiruvallur Tiruvarur Meenakshi Dental College Sarada Krishna Homoeopathic Sathyabama Dental College Shollinganallur Tobacco Smoking in Tamil Nadu Smokeless Tobacco use in Tamil Nadu Medical College Kanyakumari Dindigul Tagore Dental College and Adyar Pudukkottai (Percentage of adults age 15 and above) (Percentage of adults age 15 and above) Sengunthar College of Engineering Erode

Madurai Sivaganga Tiruvallur Tiruvallur Theni Tamil Nadu Chennai Tamil Nadu Chennai Vellore Vellore Study Group Telephone Interview & Quality Check

Kanchipuram Kanchipuram Krishnagiri Krishnagiri Tiruvannamalai Tiruvannamalai Cancer Institute (WIA) Ms. A. Usha Rani, Ms. S Rajeswari, Virudhunagar Mr. A Sharfudeen, Cancer Institute (WIA) Dr. E. Vidhubala Ramanathapuram Dharmapuri Dharmapuri Students of Thiyagaraya College of Arts and Science Viluppuram Viluppuram Mr. Divyaraj Prabhakar College & Alagappa College of Technology Salem Salem Dr. C. Sundaramoorthy Erode Cuddalore Erode Cuddalore Nilgiris Nilgiris Dr. R. Swaminathan Thoothukudi Namakkal Namakkal Perambalur Perambalur Data Entry: Data Dots Solutions, Kumarakoil, Ariyalur Nagapattinam Ariyalur Nagapattinam Dr. E. Hemanth Raj Tirunelveli

Coimbatore Tiruchirappalli Coimbatore Tiruchirappalli Kanyakumari District. Tirupur Karur Tirupur Karur Dr. V. Surendran Thanjavur Thanjavur Tiruvarur Tiruvarur International Union against Dindigul Dindigul Special Thanks Pudukkottai Pudukkottai Tuberculosis and Lung Diseases Kanyakumari Training Orientation and Research Centre (TORC), Madurai Sivaganga Madurai Sivaganga Theni Theni Dr. Hemant Schewade Mr. Pranay Lal National Service Scheme, Madras of Social Work,

Virudhunagar Virudhunagar , Chennai. Ramanathapuram Ramanathapuram Organizations involved in pre-test: Dr. Aswath Narayanan, Indian Association of Public Health Dentistry. Tuticorin Tuticorin Madras School of Social Work, Egmore, Chennai Tirunelveli Tirunelveli Hindustan Institute of Technology and Science, Chennai 0 Percentage Percentage GVN Multispeciality Hospital (Oncology unit), Trichy Funding Kanyakumari Kanyakumari RESOURCE CENTRE FOR TOBACCO CONTROL (RCTC) < 5.0 < 5.0 5.1 - 10.0 5.1 - 10.0 District Co-ordinators Birla Sun Life Asset Management Company CANCER INSTITUTE (WIA), ADYAR, CHENNAI - 600 036. K. Murali, R. Sathish, D. Dinesh Limited Cancer Institute (WIA) Tamil Nadu Tobacco Survey (TNTS) 2015 - 2016 FACT SHEET Tamil Nadu Tobacco Survey (TNTS) 2015 - 2016 FACT SHEET Tamil Nadu Tobacco Survey (TNTS) 2015 - 2016 FACT SHEET

BACKGROUND TNTS Highlights Overall Men Women Urban Rural TNTS is a large statewide population based survey Tobacco Use (%) (%) (%) (%) (%) Percentage of adult population by type of tobacco use TOBACCO USE conducted in all the 32 districts of Tamil Nadu, representing both rural and urban population. The survey interviewed about 100, TOBACCO USE IN TAMIL NADU Overall Current Tobacco Users 5.2 4.3 0.9 2.5 2.8 [ An estimated 28, 64, 400 people aged 15 years & above in 000 individuals aged 15 years and above. The aim of the survey Tamil Nadu, use tobacco in any form. Tobacco Smokers 2.8% was to systematically monitor the tobacco use (in any form) and 3.9% [ Overall prevalence of tobacco use in Tamil Nadu was 5.2% track the key outcome indicators for tobacco control based on Current tobacco smokers 3.1 3.0 0.2 1.6 0.9 33.8% 59.5% [ Tobacco use among males was higher (4.3%) compared to WHO’s MPOWER guidelines. Current cigarette smokers 1.7 1.7 0.1 1.1 0.1 females (0.9%) TNTS will assist the state of Tamil Nadu in fulfilling the Current bidi smokers 1.3 1.3 0.1 0.5 0.8 obligations of Framework Convention on Tobacco Control Smoking tobacco-3.3% (Cigarette users - 1.7%, Bidi users - 1.4%) Thanjavur 1.2 % Smokeless tobacco - 2.1% (FCTC) by developing appropriate tobacco control policies at the Current Cherot smokers 0.1 0.0 0.0 0.0 0.0 district level and allocating resources accordingly. The data Sivagangai 1.6 % [ Highest prevalence rate was observed in Pudukottai District generated can be helpful in making comparisons across and Ex-users of tobacco smoking 1.5 1.3 0.2 0.8 0.8 (19.9%) and the lowest was in Tanjavur district (1.2%) Dindigul 1.9 % within districts. [ No differences in tobacco use between urban (2.5%) and Tuticorin 2.1 % Smokeless Tobacco Users Percentage of male adult population METHODOLOGY by type of tobacco use rural areas (2.6%) of Tamil Nadu Ramanathapuram 2.9 % Current smokeless tobacco users 1.3 0.9 0.4 0.5 0.7 [ Tobacco use prevalence had come down from 16% in the Vellore 2.9 % year 2009-2010 (Global Adult Tobacco Survey: 2009-2010) A total of 111,363 eligible individuals were identified from Current tobacco chewers 1.1 0.8 0.3 0.4 0.6

to 5.2% in the year 2015-2016 in Tamil Nadu. 32,945 households, of which 99,825 individuals completed the Madurai 3.1% 5.2% 1.6% interview. The overall Household Response Rate (HRR) was Current snuff users 0.2 0.1 0.1 0.1 0.1 [ Average age at initiation of tobacco use was 24.7 years; 23% 70.3% 91.23% and Individual Response Rate was 89.24%. The Global Theni 3.1% 25.7% of the respondents initiated the use before the age of Ex- users of smokeless tobacco 1.5 1.3 0.2 0.8 0.8 Adult Tobacco Survey (GATS) questionnaire was modified and 3.3% 18 years. Thiruvarur translated into the local language (Tamil). A total of 31 Current Dual Tobacco Users [ 47% of current tobacco users consumed tobacco within Krishnagiri 3.4% 1.0 0.1 0.5 0.4 0.6 educational institutions and three NGOs participated in (Smoking and Smokeless) half an hour of waking up. conducting in the survey. Virudhunagar 3.5% CESSATION TNTS assessed the prevalence of tobacco use, exposure to Tiruvannamalai 3.7% [ 54% of the current users were concerned about their secondhand smoke, cessation, the impact of tobacco control Kancheepuram legislations and prevention initiatives in Tamil Nadu. This study 4.0% tobacco use Percentage of female adult population used the traditional paper-based questionnaire. The data was Salem 4.1% Overall Men Women Urban Rural [ 17.2% of the current users reported that they were thinking by type of tobacco use double-entered using an open access tool (Epidata).The quality Media (%) (%) (%) (%) (%) of quitting in the next one month Karur 4.3%

of the data was ensured at multiple stages, from data collection to Districts [ 38.9% of the current users had made an effort to quit entry. Coimbatore 4.3% Adults who noticed any anti - tobacco messages which motivates quitting in the last one month tobacco in the last 12 months 1.7% 8.1% 14.2% Tiruvallur 4.3% TV 77.1 38.1 39.0 39.6 37.5 Cessation methodologies used were counseling Namakkal 4.4% 75.9% (14.3%), NRT & Medication (3.4%), Self attempt Smoking tobacco Radio 11.6 6.0 5.6 5.3 6.3 (7.1%) SMOKE FREE POLICIES AT HOME AND WORK PLACE Villupuram 4.6% [ News paper 14.6 7.8 6.8 7.4 7.2 [ 34.9% current users were asked for their tobacco use by a 96.6% of the respondents reported that smoking is not Tamil Nadu 5.2% Chewing tobacco health care provider in the last 12 months permitted at their home, however 15% of the houses had people smoking at home, daily Kanyakumari 5.5% Snuff Bill board 13.4 7.2 6.2 7.4 6.0 [ 37.7% of the current users were advised by a health care [ Ariyalur 5.5% provider to quit tobacco 15.7% of the respondents reported that their workplace did Tobacco packs 6.0 3.4 2.6 3.1 2.9 not have any smoke free policy and in 5.7% of the workplaces, Dual users PICTORIAL WARNING Erode 5.7% smoking was allowed everywhere Films 23.3 12.2 11.1 12.2 10.5 Smoking tabacco Smokeless tobacco [ Perambalur 5.7% 67.3% of the current tobacco users noticed pictorial Dual users Snuff users warning on the tobacco products they used, in the last one MEDIA Dharmapuri 5.8% Theatre 15.9 8.9 7.0 9.1 6.9 month. [ Respondents who noticed anti-tobacco messages in the last Nilgiris 6.2% Not seen 8.1 3.8 4.3 3.5 8.1 Smokers-63.6%,(Cigarettes-38.5%, Bidi-25.2%), one month: 91.9% Smokeless tobacco users-32%, Dual users-4.3% Tirunelveli 6.3% Te l e v i s i o n - 7 7 . 1 % , N e w s p a p e r - 1 4 . 6 % , Adults who noticed any advertisement or promotion of tobacco products in the last one month Overall Men Women Urban Rural Cessation (%) (%) (%) (%) (%) [ Of the current tobacco users who noticed pictorial warning, Films-23.3%, Theatre - 16% Tiruchirapalli 6.4% TV 12.3 6.3 6.0 5.0 7.2 61.3% were motivated to quit [ 78.4% of the respondents noticed tobacco advertisement or Chennai 6.6% Current tobacco users who are either planning promotional messages in the last one month or thinking of quitting in the past one year Smokers-64.2%, (Cigarettes-37.4%, Bidi-26.8%), Tiruppur 7.2% Radio 2.6 1.4 1.2 1.3 1.4 Smokeless tobacco users-29.7%, Dual users-3.6% Television 12.2 %, News paper 2.9 %, Smoking tobacco 15.0 14.1 0.8 8.7 6.3 Nagapattinam 8.9% News paper 3.0 1.6 1.4 1.3 1.7 SECTION 6A Films 3.4 %, Theatre 2.7% Cuddalore 12.1% Smokeless tobacco 7.6 4.6 3.0 3.7 3.9 [ 29% of the respondents aged below 18 years were refused KNOWLEDGE, ATTITUDE AND PERCEPTION Bill board 2.2 1.2 1.0 1.1 1.1 tobacco products by shopkeepers, attributing to their age Pudukottai 19.9% [ 95% of the respondents were aware that tobacco causes Tobacco packs 1.1 0.6 0.5 0.6 0.5 Current users advised by health care providers GUTKHA BAN serious illness. in the past one year [ 90.3% of the current Smokeless Tobacco (SLT) users had no 0 5 10 15 20 [ 70.6% of the respondents believed exposure to tobacco smoke Films 3.5 1.9 1.6 1.9 1.6 difficulty in procuring the banned Gutkha products in Smoking tobacco 23.8 22.9 0.9 11.9 11.9 causes serious illness among non-smokers. Tamil Nadu Percentage Theatre 2.6 1.4 1.2 1.3 1.3 [ Respondents attributed tobacco use with Cancer - 80%, Heart Smokeless tobacco 12.2 7.0 5.2 4.9 7.3 [ Current SLT users paid double the price to procure Gutkha attack – 33.5%, Infertility- 4.6%. Not seen 78.4 38.5 39.9 40.5 37.9 after the ban in Tamil Nadu