Prevalence and Factors Associated with Tobacco Use Among Pregnant and Breastfeeding Mothers in India: Insights from the National Family Health Survey-5 (2019-21)

Rachita PradhanRutuparna Sibani DandsenaSneha SinghShishirendu GhosalDEBDUTTA BHATTACHARYASrikanta Kanungo^*Sanghamitra Pati^*

• Regional Medical Research Center (ICMR), Bhubaneswar, India

Tobacco use remains a major public health concern, particularly in low-and middle-income countries, accounting for 80% of global users. In India, uncontrolled price and illicit trading have facilitated the tobacco-menace to break the gender-barrier. In India, smokeless tobacco (SLT) use is higher among women, likely due to financial dependence from limited occupational engagement, peer influence and gender inequality. Tobacco consumption in any form, poses significant health risk for the mothers and the children, both.Continuing tobacco use during pregnancy and breastfeeding can harm the developing foetus or the growing neonate.This study aims to estimate the prevalence and factors associated to smoking tobacco and SLT among pregnant and breastfeeding mothers from the fifth National Family Health Survey (2019-21) (NFHS-5), in India.After excluding the outliers, 722,933 women of reproductive age (24,368 pregnant, 102,080 breast-feeding and 592,699 non-pregnant/non-breastfeeding mothers) were found eligible for this cross-sectionally collected secondary data analysis. Descriptive statistics were presented as mean with standard deviation (continuous variable) or frequency (categorical variable) with 95% confidence interval as a measure of uncertainty. Magnitude of influence by the covariates of tobacco consumption were estimated through univariate and multivariable logistic regression.Around 3.2% of the mothers accepted consuming tobacco during current pregnancy or breastfeeding. Their predilection towards smokeless tobacco (SLT) was >13 times higher than smoking tobacco. Strong predictors of SLT Cconsumption emerged as ption oftrial SLT was highly associated with ethnicity of the pregnant/breastfeeding mothers being tribal [AOR: 2.20 (1.95-2.48)] and early motherhood emerged as a risk-factor for tobacco consumption [AOR: 1.12 (1.08-1.16)]. Effort Awareness spread throughof mass-median failed miserably to protect the mothers in from consuming SLT cessation failed significantly ]. Marked difference in prevalence was found between pregnant (2.48%) and breastfeeding mothers (3.34%), suggesting possible relapse postpartum. This highlights the potential role of Accredited Social Health Activists (ASHAs) during antenatal care (ANC) visits in offering consistent tobacco cessation support.Using tobacco comes not only with the health hazards to the mother; it can jeopardise the young life growing within her too. Our findings indicate lack of management and awareness demanding substantial reformations in tobacco production and vending for a better maternal and child care.