Guwahati: Tobacco consumption has risen significantly across India over the past decade, with several states in the Northeast emerging among the highest consumers in the country, according to a new analysis based on national household data.
The findings come from a working paper, “Rise in Tobacco Consumption and Policy Implications: An Analysis of Household Consumption Expenditure Survey 2011–12 and 2023–24,” authored by Shamika Ravi, a member of the Economic Advisory Council to the Prime Minister, and Partha Protim Barman.
Drawing on data from the Household Consumption Expenditure Survey (HCES) 2023–24, the study highlights a sharp nationwide increase in tobacco use, with particularly high prevalence across both rural and urban areas in the Northeast.
In rural India, states such as Tripura, Arunachal Pradesh, Mizoram and Meghalaya reported some of the highest levels of tobacco consumption in the country. Tripura topped the list, with 96.4% of rural households reporting tobacco use, followed by Arunachal Pradesh (94.3%), Mizoram (92.7%) and Meghalaya (89.8%). These figures are well above the national rural average of 68.5%.
A similar pattern was observed in urban areas. Mizoram recorded the highest tobacco consumption at 91%, followed by Tripura (89.8%) and Arunachal Pradesh (83%), placing Northeast states among the top consumers nationwide.
Overall, tobacco use has expanded rapidly across India. The number of rural households consuming tobacco rose from 9.9 crore in 2011–12 to 13.3 crore in 2023–24, while urban households increased from 2.8 crore to 4.7 crore — marking a 33% rise in rural areas and a 59% increase in urban centres.
The study notes a shift in consumption patterns, with packaged tobacco products such as gutkha and cigarettes seeing sharp increases, even as traditional products like bidi decline. Researchers attribute this to aggressive marketing and wider availability of commercially packaged products.
In the Northeast, gutkha consumption remains higher than the national average in states including Tripura, Sikkim, Nagaland, Arunachal Pradesh and Assam. However, a marginal decline was observed in Meghalaya (from 8.8% to 7%) and Mizoram (from 5.1% to 1.2%).
At the national level, gutkha consumption in rural India surged from 5.3% of households in 2011–12 to 30.4% in 2023–24. Cigarette use also increased from 4.8% to 11.2% over the same period. Urban areas recorded similar trends, with gutkha consumption rising from 3.07% to 16.8%, and cigarette use from 8.4% to 18%.
The report also highlights distinct regional patterns. Cigarette smoking is particularly high in Mizoram, where 85.9% of rural households reported cigarette use — the highest in the country. Meanwhile, leaf and chewing tobacco continue to be widely used in Assam, with over half of rural households consuming such products.
The analysis points to some modest gains as well.
Meghalaya and Mizoram have seen slight declines in gutkha consumption, suggesting that targeted awareness campaigns and regulatory efforts may be yielding results.
However, the burden of tobacco use remains disproportionately high among poorer households. More than 70% of rural households in the bottom 40% income group consume tobacco, compared to about 63% among the richest 20%.
Researchers warn that such spending diverts resources away from essential needs like nutrition, education and healthcare, especially among low-income families.
The study also cautions that rising tobacco consumption could exacerbate India’s growing burden of non-communicable diseases, including cardiovascular illnesses, cancer and respiratory conditions. Tobacco use is linked to an estimated 1.3 million deaths annually in the country.
With public healthcare coverage expanding, the report warns that increasing tobacco-related illnesses could place additional strain on government health systems.
It calls for stronger regulation and enforcement, citing concerns over surrogate advertising, the “twin-product” strategy used by manufacturers to bypass restrictions, and the easy availability of smokeless tobacco.
Without more stringent intervention, the study warns, tobacco consumption is likely to continue rising despite broader public health efforts.