Evaluating the Impact of Tobacco Consumption on Hypertension among Adult Females: Evidence from National Family Health Survey-IV for Odisha, India

Background: Every fourth person on the earth is hypertensive. Hypertension is the third killer disease in the list of all age mortality. Elevated blood pressure and tobacco consumption have been the top two causes of preventable mortality worldwide. Females in the reproductive age carry a higher health impact for self and their offspring when exposed to one or both of these risks.

Aim: The aim of the study is to assess the sociocultural determinants of hypertension and tobacco usage.

Methods: An in-depth assessment of the sociocultural determinants of hypertension and tobacco usage in an aspirational Indian state like Odisha is carried out through secondary analysis of the National Family Health Survey-IV (NFHS-4) dataset. Data from 30,587 women aged between 15 and 49 years were extrapolated for analysis through frequency, percentage and logistic regression models to determine the predictors of tobacco use and hypertension and to correlate the two in the study population. Data were analyzed using SPSS software version 21.

Results: In Odisha, 12.8% of adult women were addicted to tobacco, mostly in smokeless form (93.3%). High blood pressure was recorded in 7.3% of the respondents females. The mean systolic and diastolic blood pressure readings in the hypertensive group were 154.53 (±SD 24.254) and 96.66 (±S.D 16.554) mmHg respectively. Increasing age, urban residence, extremes of wealth index, ever-married status, obesity, diabetes, and tobacco usage (more for smokeless) were the predictors of hypertension. Education, caste and occupation had no significant associations. The present study reports tobacco abuse to be a significant (1.8-fold) determinant of hypertension in adult females even after adjustment of other confounders.

Conclusion: The combination of multiple risk factors—such as residence, wealth status, marital status, age, and caste—contributes to both tobacco use and hypertension in adult females of reproductive age. Health policies and planning need to be prioritized towards a targeted approach instead of a ‘one size fits all’ approach followed to date so far as prevention and control of risk factors of tobacco usage and non-communicable diseases like hypertension are concerned. Targeted interventions involving gender, marital status, obesity, residence and other socio-economic profiles may be adopted for risk reduction of non-communicable diseases like hypertension in reproductive-age females.