LAUSR

Abstract Background Substance use – defined by the consumption of alcohol, smoking, and smokeless tobacco - has been identified as a serious health hazard in India. Understanding the socioeconomic correlates of substance use in Northeast India (NEI) will provide crucial input for public health policies in this region. Objectives To examine the socioeconomic correlates of substance consumption among male adults of NEI. Data and methods We analyzed nationally representative data from the National Family Health Survey (NFHS-4) 2015–2016. We examined the prevalence and frequency of smoking, using smokeless tobacco products, alcohol consumption, and other substance use among 14,555 men in the 15 to 54-year age group. We carried out binary logistic regressions to investigate the socioeconomic correlates of substance use among male adults in NEI. Results Substance use was significantly higher among the male adults of NEI than among those from elsewhere in the country (any substance i.e. smoking, smokeless tobacco and alcohol use in India: 50.03% vs. NEI: 70.83%). The frequency of smoking and alcohol consumption is also higher in NEI compared to the rest of the country. In total, there are about 10.2 million substance users, of which 6.7 million are from the state of Assam. About 44.38% of adolescents (aged between 15 and 19) use at least one type of substance. Substance use plateaus in the 25 to 49 age group before beginning to decline among users aged between 50 and 54 years. The likelihood of substance use goes down with increasing education and wealth in NEI. Among social groups, Scheduled Tribe adults have the highest likelihood of using any substance. Conclusion The intensity of substance consumption in NEI is very high. These unhealthy behaviors are more prevalent among socioeconomically disadvantaged populations. This calls for intensive research to better understand the dynamics of substance availability and use in NEI. Furthermore, strong policy measures are needed to reduce substance use among vulnerable groups.