By  Ashraf Padanna/Thiruvananthapuram

The first-ever study on tobacco use in Kerala, says 21.1% of young men (15-24 years) are prone to the smoking habit while 22.2% of men between the ages of 55 and 64 gravitated towards smokeless tobacco products over seven years.
The study also recommends effective implementation of the Cigarettes and Other Tobacco Products Act (COTPA), 2003, to tackle the worrisome incidence of tobacco use.
The findings of the study, conducted in rural areas of Thiruvananthapuram district, have been summarised in an article titled ‘Incidence of Tobacco Use Among Adults (15-64 years) in Rural Kerala’ published in a recent edition of Asia-Pacific Journal of Public Health.
Dr T Sathish, Dr Srinivasan Kannan, Dr P Sankara Sarma and Dr K R Thankappan of the Sree Chitra Tirunal Institute for Medical Sciences and Technology here are behind the study. The study evaluated the incidence of current smoking and current smokeless tobacco use over a seven-year period in a sample of 452 males and females aged 15 to 64 years using the World Health Organisation’s STEPS approach.
The STEPS approach is an instrument of chronic disease risk factor surveillance and has three steps, viz., questionnaire, physical measurements and biochemical measurements. At the start of the study in 2003, of the total of 452 persons, 385 were current non-smokers and 402 were current non-users of smokeless tobacco products.
A follow-up conducted in 2010 showed that 14.3% and 14.2% men became current smokers and current smokeless tobacco users respectively.
Current smokers and current smokeless tobacco users are defined as those who had used any of these products in the last 30 days. Smoking products include cigarettes and bidis while smokeless tobacco products included in the study are snuff, betel quid with tobacco, gutkha or khaini.
Incidence of smoking or the measure of risk of acquiring the habit has been obtained by dividing the number of new current smokers at follow-up by the number of current non-smokers during baseline.
A similar process was followed to understand the incidence of smokeless tobacco use. Incidence of current smoking and current smokeless tobacco use is of initiation and/or relapse. The study also throws up the trend of smokeless tobacco use among women; 9.7% of older women (55-64 years) became current smokeless tobacco users. While there is seen a shift of preference from smoking to smokeless tobacco among men; it does not however translate itself to total abstinence from smoking.