NFHS-6 Flags Rise In Men's Alcohol Use And Women's Tobacco Consumption Across Several States

Mumbai, June 22: India may have recorded a slight decline in overall tobacco and alcohol consumption, but the latest National Family Health Survey (NFHS-6) data reveals worrying trends emerging beneath the national averages.

While alcohol consumption among men has increased in several states, tobacco use among women has risen across 13 states and Union Territories, signalling new public health challenges.

The NFHS-6 (2023-24) data shows that liquor consumption among men aged 15 years and above rose nationally from 18.7% to 18.9%. Tobacco use among women, meanwhile, increased in multiple states despite a marginal decline in the national average from 8.9% to 8.4%.

A Hidden Crisis Behind National Averages

Health experts warn that national figures may be masking serious regional problems. According to Dr Shalini Singh, Director of the Indian Council of Medical Research-National Institute of Cancer Prevention and Research (ICMR-NICPR), Noida, state-level and district-level trends deserve greater attention, TNIE reported.

"A national average that appears favourable can mask subnational crises," Singh said, stressing the need for localised assessments and interventions rather than relying solely on national targets.

The survey found that tobacco use among women aged 15 years and above increased in Arunachal Pradesh, Chhattisgarh, Goa, Himachal Pradesh, Madhya Pradesh, Meghalaya, Nagaland, Punjab, Sikkim, Telangana, Uttar Pradesh, West Bengal and Puducherry.

Among these states, Meghalaya recorded one of the sharpest increases, with tobacco use among women rising from 28.3% to 34.6%. Nagaland also saw a significant jump from 13.7% to 17.4%, while Madhya Pradesh recorded an increase from 10.3% to 11.6%.

Rising Tobacco Use Among Women Worries Experts

Public health experts view the increase in tobacco use among women as a particularly troubling development because of its impact on maternal and child health.

Singh said tobacco use during pregnancy is linked to adverse birth outcomes, including low birth weight, preterm birth and increased infant mortality. Previous rounds of NFHS data had also shown high use of smokeless tobacco among pregnant women in several central, eastern and north-eastern states.

She called for gender-sensitive tobacco control measures, including targeted information and awareness campaigns, integrating tobacco cessation into maternal and reproductive health programmes, and stronger regulation of smokeless tobacco products marketed to women.

The survey also showed that tobacco consumption among men remains high in several states. Although the national figure fell from 38% to 36.3%, increases were recorded in Arunachal Pradesh, Chhattisgarh, Madhya Pradesh, Mizoram, Nagaland, Punjab, Uttar Pradesh, Uttarakhand, Chandigarh and Lakshadweep.

In Mizoram, nearly three-fourths of men aged 15 years and above reported using tobacco, with the figure rising from 73.1% to 73.6%.

Alcohol Use Rises Despite Prohibition

The NFHS-6 data also points to increasing alcohol consumption among men in 14 states and Union Territories. States reporting higher consumption include Andhra Pradesh, Bihar, Chhattisgarh, Haryana, Kerala, Madhya Pradesh, Nagaland, Punjab, Sikkim, Telangana, Uttar Pradesh, Uttarakhand, Chandigarh and Lakshadweep.

Bihar, where liquor prohibition is in force, saw consumption among men rise from 15.4% to 16.5%. Similar increases were also recorded in Nagaland, another dry state.

Interestingly, Gujarat appeared to be the only prohibition state where alcohol consumption declined among both men and women. Among men, the figure fell from 5.8% to 5.2%, while among women it dropped from 0.6% to 0.3%.

Although alcohol consumption among women declined nationally from 1.3% to 1.1%, increases were recorded in Andhra Pradesh, Chhattisgarh, Kerala, Madhya Pradesh, Nagaland, Sikkim, Telangana and Chandigarh.

Sikkim recorded the highest rise among women, with alcohol consumption increasing from 16.2% to 19.9%.

Rural India Faces A Bigger Burden

The survey also highlights a growing rural-urban divide. Men and women in rural India consume more tobacco and alcohol than their urban counterparts.

According to Singh, this is linked to lower literacy levels, weaker health awareness, limited access to healthcare and cessation services, easier availability of tobacco and alcohol products, and the prevalence of physically demanding occupations where substance use is often socially accepted.

She noted that tobacco cessation clinics, counselling services and non-communicable disease screening facilities remain heavily concentrated in urban and peri-urban areas.

The findings, she said, strengthen the case for integrating tobacco and alcohol screening into frontline healthcare services and expanding cessation support through Ayushman Bharat-Health and Wellness Centres.

The latest NFHS data presents a mixed picture. While national averages suggest modest improvements, state-level trends reveal that tobacco and alcohol consumption continue to pose a significant public health challenge.

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Experts believe the figures underscore the need for targeted interventions, particularly for women and rural populations, if India is to effectively tackle its growing burden of non-communicable diseases such as cancer and cardiovascular disease.

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