Comparative assessment of tobacco use patterns and determinants among urban slum and non-slum dwellers in Vijayawada city: A community-based cross-sectional study.

Background: Tobacco use remains a major public health challenge, contributing significantly to morbidity and mortality, especially among urban slum populations where socio-economic disparities prevail. Understanding the determinants and patterns of tobacco consumption in diverse urban settings is critical for effective tobacco control strategies. Objectives: To assess and compare the determinants and patterns of tobacco use among adult male slum and non-slum dwellers of Vijayawada city. Methods: A community-based cross-sectional descriptive study was conducted among 2008 participants (1215 non-slum and 793 slum residents) in Vijayawada. A multistage random sampling technique was used. Data on socio-demographic profile, tobacco use habits, and influencing factors were collected through a pre-tested semi-structured questionnaire. Statistical analysis was performed using SPSS version 20.0, with significance set at p < 0.05. Results: The prevalence of ever tobacco users was 35.3%, with current tobacco use at 30.7%. Tobacco use was significantly higher among males (39.5%) than among females (21.5%) (p < 0.001). Slum residents exhibited a higher prevalence of current use (32.9%) compared to non-slum residents (29.3%). Smoking-only habits were predominant (58.5%), but dual use (15.7%) and smokeless tobacco use (26.0%) were notable among females. Illiteracy (50.2%), low socio-economic status (Class V, 44.5%), and occupation as labourers (58.8%) were strongly associated with higher tobacco use. Initiation of tobacco use before 20 years was common (59.2%). Social influence from family (63.2%) and peers (74.5%) was significant, though 85.9% of users were aware of health hazards. Conclusion: Tobacco use patterns are deeply entrenched in socio-economic, educational, and cultural contexts, with slum dwellers and disadvantaged groups exhibiting higher prevalence. Early initiation and strong social influences underscore the need for targeted interventions. Recommendations: Strengthen community-level education, enforce policy measures, and integrate tobacco cessation programs with socio-economic upliftment schemes for slum populations to reduce the tobacco burden.