Defining the socio-economic and environmental determinants for high tobacco consumption behaviors among interstate migrant construction workers in Chennai: an observational analysis

Sree T. Sucharitha, Balaji Arumugam, Suganya E., Divyadharshini S., Akshaya P.


Background: Global Adult Tobacco Survey-2 (GATS) reveals significant improvements in the decline of tobacco consumption in the past decades, however vulnerable population groups such as migrant construction workers tobacco consumption behaviors in Chennai remain understudied, thus the study was planned to estimate the socio-economic and environmental determinants for high tobacco consumption behaviors among interstate migrant construction workers in Chennai.

Methods: A cross sectional survey was undertaken using a pre-tested structured questionnaire adapted from GATS survey questionnaire assessing the socio-demographic and environmental determinants for tobacco use among study population across 13 construction sites in Chennai during May-September 2019. Data was entered in MS-Excel and analysed using SPSS.

Results: Among 345 migrant construction workers, mean age of the subjects was 28.42±8.7 years, 338 (98%) were current tobacco users by smoking, chewing, snuffing, of whom 198 (58.6%) used smokeless forms of tobacco like gutkha, khaini, chewing tobacco leaves, betel quid, tobacco snuff, 98 (29%) were smokers and 42 (12.4%) were dual users i.e. both cigarettes and beedis. Khaini (57%) is the dominant form of tobacco used among migrant construction workers. Mean age of initiation of tobacco use was 21.58 years and 21.17, and 22.73 and 19.5 years for smoking, SLT and dual users respectively. The migrant construction workers with no formal literacy(p=0.000), monthly income of more than 10000 (p=0.020) Indian rupees and migrants for less than one year duration (p=0.05)were more likely using the smokeless tobacco than any other socio demographic group.

Conclusions: Tobacco prevalence especially smokeless tobacco use is alarmingly high among interstate migrant construction workers to Chennai.


Construction worker, Current users, Migrants, Smoking, Smokeless tobacco, Tobacco usage

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Tata Institute of social Sciences (TISS), Mumbai and Ministry of Health and Family Welfare, Government of India. Global Adult Tobacco Survey GATS 2 India 2016-17. Available at: http://www. Accessed on 3 January 2020.

WHO. Global Youth Tobacco Survey (GYTS): India - 2009. Geneva: World Health Organization; 2010.

Chockalingam L, Vedhachalam K, Rangasamy C, Sekar S, Adinarayanan G, Swaminathan S, et al. Prevalence of Tobacco Use in Urban, Semi Urban and Rural Areas in and around Chennai City, India. PloS one. 2013;8:76005.

WHO global report on trends in prevalence of tobacco smoking 2000-2025. Available at Accessed on 10 January 2010.

Lal PG, Wilson NC, Gupta PC. Attributable deaths from smoking in the last 100 years in India. Curr Sci. 2012;103(9):1085-90.

Tamil Nadu now home to 1 million migrant workers. Available at http:// times Accessed on 10 January 2020.

Gawde NC, Sivakami M, Babu BV. Utilization of maternal health services among internal migrants in Mumbai, India. J Biosoc Sci. 2016;48:767-96.

Kusuma YS, Kumari R, Kaushal S. Migration and access to maternal healthcare: determinants of adequate antenatal care and institutional delivery among socio-economically disadvantaged migrants in Delhi, India. Trop Med Int Health. 2013;18:1202-10.

Heaman M, Bayrampour H, Kingston D, Blondel B, Gissler M, Roth C, Alexander S, et al. Migrant women's utilization of prenatal care: a systematic review. Matern Child Health J. 2013;17:816-36.

Aslesh OP, Paul S, Paul L, Kumaran A. High prevalence of tobacco use and associated oral mucosal lesion among interstate male migrant workers in urban Kerala, India. Iran J Cancer Prev. 2015;8(6):e3876.

Ali AK, Mohammed A, Thomas AA, Paul S, Shahul M, Kasim K. Tobacco abuse and associated oral lesions among interstate migrant construction workers. J Contemp Dent Pract. 2017;18(8):695-9.

Parashar M, Dwiwedi S, Singh M, Patavegar B, Bhardwaj M. Tobacco use behaviour among construction site workers of Delhi, India. Int J Health Allied Sci. 2017;6;210-4.

Zabeer S, Inbaraj LR, George CE, Norman G. Quality of life among migrant construction workers in Bangalore city: a cross-sectional study. J Family Med Primary Care. 2019;8(2):437-42.

Amrutha AM, Karinagannanavar A, Ahmed M. Proportion of smokers and its determinants among migrant workers in Mysore, Karnataka, India. Int J Community Med Public Health. 2016;3(4):856-60.

Global Adult Tobacco Survey Collaborative Group. Global Adult Tobacco Survey (GATS): Core Questionnaire with Optional Questions, Version 2.1. Atlanta, GA: Centers for disease control and prevention. 2014.

Rameshan A, George LS, Ramakrishnan D, Vasudevan A. Study on oral smokeless tobacco use among migrant labourers and their attitude towards tobacco cessation in an urban settlement in Ernakulam district of Kerala. Int J Community Med Public Health. 2019;6:2152-6.

Adsul BB, Laad PS, Howal PV, Chaturvedi RM. Health problems among migrant construction workers: a unique public-private partnership project. Indian J Occup Environ Med. 2011;15:29-32.

Mishra A, Sharma D, Tripathi G, Adhikari P, Kabirpanthi V, Kumar M. Pattern and prevalence of tobacco use and associated oral mucosal lesions: a hospital based cross sectional study at a tertiary care hospital in central India. Int J Res Med Sci. 2015;5:2169-73.

Commonly used smokeless tobacco products around the globe. Available at https:// untobaccocontrol. org/kh/smokeless-tobacco/paan-betel-quid-tobacco/. Accessed on 10 December 2019.

Chewing tobacco products-storehouse of toxic chemicals. Available at https:// www. Thehindu Accessed on 10 December 2019.

Gutkha scam: Why nobody cares to see what's inside the tiny packets? In India, unless you are part of a big scam, you don't get as much attention. Available at Accessed on 10 January 2020.

Heatherton TF, Kozlowski LT, Frecker RC, Fagersrom KO. The fagerstrom test for nicotine dependence: a revision of the fagerstrom tolerance questionnaire. Br J Addict. 1991;86:1119-27.

Pomerleau CS, Majchrezak MI, Pomerleau OF. Nicotine dependence and the fagerstrom tolerance questionnaire: a brief review. J Substance Abuse. 1989;1:471-7.

Migration in India. Available at http:// sites/default/files/publication_reports/533_final.pdf. Accessed on 10 January 2020.

Islam K, Saha I, Saha R, Abdul S, Khan S, Thakur R, et al. Predictors of quitting behaviour with special reference to nicotine dependence among adult tobacco-users in a slum of Burdwan district, West Bengal, India. Indian J Med Res. 2014;139:638-42.

Panda R, Venkatesan S, Persai D, Trivedi M, Mathur MR. Factors determining intention to quit tobacco: exploring patient responses visiting public health facilities in India. Tob Induc Dis. 2014;12(1):1.

Kumar SM. Community based group intervention for tobacco cessation in rural Tamil Nadu: a cluster randomized trial. J Subst Abuse Treat. 2012;43(1):53-60.

Okechukwu C, Bacic J, Cheng KW, Catalano R. Smoking among construction workers: The nonlinear influence of the economy, cigarette prices, and antismoking sentiment. Soc Sci Med. 2012;75:1379-86.

Ham DC, Przybeck T, Strickland JR, Luke DA, Bierut LJ, Evanoff BA, et al. Occupation and workplace policies predict smoking behaviors: Analysis of national data from the current population survey. J Occup Environ Med. 2011;53:1337-45.