{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T11:20:22Z","timestamp":1783682422815,"version":"3.55.0"},"reference-count":34,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Tob Use Insights"],"published-print":{"date-parts":[[2026,2,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tobacco use is a leading cause of preventable morbidity and mortality globally, with early initiation strongly linked to lifelong dependence and adverse health outcomes. In India, socio-cultural and economic heterogeneity complicates tobacco control, particularly among youth. Understanding early initiation patterns is essential for designing age-targeted interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The present study aims to use GATS-2 data to estimate the age of initiation of tobacco use in India, assess the prevalence of early initiation across population subgroups, and identify its key socio-demographic and economic correlates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from GATS-2 (2016-17), a nationally representative cross-sectional survey in India. The sample included 7647 ever-smokers and 12\u00a0772 ever-users of smokeless tobacco aged \u226515\u00a0years. Early initiation was defined as starting tobacco use at age \u226414. Weighted bivariate and multivariate logistic regression analyses were performed using STATA v17.0.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Early initiation occurred in 8.0% of smokers and 10.4% of smokeless users, with over half initiating between ages 15-24. Scheduled Tribes and Muslims had higher early use, while education showed a strong protective effect; postgraduates were 87% less likely to initiate early. Students (AOR = 5.31) and the unemployed (AOR = 2.14) faced greater risk. Rural residence lowered odds for early smoking (AOR = 0.22) but increased it for smokeless use (AOR = 1.16). Females had 36% higher odds for early smokeless tobacco use. High-burden states included Sikkim, Bihar, Odisha, and Arunachal Pradesh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early tobacco initiation in India is prevalent among youth, marginalized groups, and certain regions. Strengthened education, policy enforcement, and culturally tailored interventions are vital to curb long-term dependence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1179173x251372804","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:11:21Z","timestamp":1770984681000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Early Initiation of Tobacco Use and its Socio-Demographic Correlates in India: Evidence From the Global Adult Tobacco Survey (GATS-2)"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4174-907X","authenticated-orcid":false,"given":"Vini","family":"Mehta","sequence":"first","affiliation":[{"name":"University of Ibn al-Nafis for Medical Sciences"},{"name":"Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth (Deemed to be University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Pardeshi","sequence":"additional","affiliation":[{"name":"Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayhan","family":"Rahman","sequence":"additional","affiliation":[{"name":"Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth (Deemed to be University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toufiq","family":"Noor","sequence":"additional","affiliation":[{"name":"Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth (Deemed to be University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankita","family":"Mathur","sequence":"additional","affiliation":[{"name":"Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth (Deemed to be University)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"WHO report on the global tobacco epidemic 2017: monitoring tobacco use and prevention policies. https:\/\/www.who.int\/publications\/i\/item\/9789241512824. 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