The number of men smoking tobacco in India rose by more than one-thirds to 108 million in 17 years, according to an alarming new study led by an Indian-origin researcher, which also found that cigarettes are replacing the traditional bidis.
The study found the number of men smoking any type of tobacco at ages 15-69 years rose by about 29 million, or 36%, from 79 million in 1998 to 108 million in 2015, representing an average annual increase of about 1.7 million male smokers.
"In 2010 smoking caused about 1 million deaths or 10% of all deaths in India, with about 70% of those deaths occurring between the ages of 30 and 69, what should be the prime of their lives," said Prabhat Jha from University of Toronto who led the study.
The overall age adjusted smoking prevalence at ages 15-69 years declined modestly from 27% in 1998 to 24% in 2010 but total numbers rose due to population growth, researchers said.
Cigarettes are replacing the traditional bidi, a small, inexpensive Indian cigarette, possibly due to substantially higher income in India and population growth, the study said.
By 2015, there were roughly equal numbers of men in age group of 15-69 years smoking cigarettes or bidis - approximately 61 million Indian adult men smoked cigarettes (40 million exclusively) and 69 million smoked bidis (48 million exclusively).
The study also found that the sharpest increase in male smoking occurred at ages 15-29 years. The highest prevalence of any smoking in men aged 15-69 years was in illiterate men in both 1998 and 2010.
The findings showed that the number of smokers rose about 68% from 19 to 31 million in urban India and about 26% from 61 to 77 million in rural India.
At the ages 15-69 years, there were about 11 million women who smoked (about one-tenth of the total of male smokers), researchers said.
The smoking prevalence in women born after 1960 was about half of the prevalence in women born before 1950, suggesting that there is no increase in young women smoking, they said.
China is the only country in the world with more smokers than India.
Smoking cessation is uncommon in India. In 2015, at ages 45-59 years, there are roughly four current smokers for every quitter, researchers said.
The findings were published in the journal BMJ Global Health.