Smokeless Tobacco Use among Pregnant Women in India: The Tale of Two Nationally Representative Surveys

The prevalence of smokeless tobacco (SLT) is pervasive in many Asian countries, including India. SLT use among pregnant women is markedly high, and is considered to be a global concern. Consequently, the associated health effects of SLT consumption on pregnant women and the foetus cause long-term adverse effects. Therefore, this article aims to understand the extent of deviation in SLT use estimates among Indian pregnant women based on two nationally representative surveys and its implications. Responses of 1,403 pregnant women were recorded in the Global Adult Tobacco Survey (GATS 2016-17), whereas 184,641 pregnant women were interviewed in the fourth round of the Demographic and Health Survey or the National Family Health Survey (DHS NFHS 2015-16). Considerable differences in SLT use patterns among pregnant women between the GATS-2 and the NFHS-4 was evident. Overall, the prevalence of SLT use among pregnant women was reported to be higher in GATS than NFHS and this pattern remains similar between age groups of 15 to 34. In the absence of reliable estimates of SLT use among pregnant women, its adverse implications for both reproductive, maternal and child health policies, tobacco control efforts and data quality issues need to be acknowledged and addressed in a targeted manner.