Patterns and predictors of tobacco and alcohol use among older and elderly patients with diabetes and hypertension: findings from the Longitudinal Ageing Study in India

Continued usage of tobacco and alcohol can aggravate the risk of cardiovascular complications in patients with diabetes mellitus (DM) and hypertension (HTN). We analyzed the individual and combined consumption patterns of alcohol, tobacco smoking, and smokeless tobacco (SLT) use and their predictors among patients with HTN, DM, and HTN–DM comorbidity.

This study used data from the LASI Wave-1 (2017–2018) dataset with 73,396 participants. Binary logistic regression was used to determine associations while controlling for other factors.

The sample included 8855 patients with DM and 20,319 patients with HTN. The weighted prevalence of tobacco smoking, SLT use, and dual user was 8.08%, 16.26%, and 1.48% respectively in patients with DM, 8.35%, 16.45%, and 0.95% respectively in patients with HTN, and 5.81%, 10.25%, and 0.85% respectively in patients with DM–HTN comorbidity. Among DM patients, males were major users of smoking tobacco (95.7%), SLT (64.31%), dual use (99.75%), and consuming alcohol (91.88%). Females with hypertension comprised a majority of SLT users (54.20%). On adjusted analysis, females, education levels of college and above, and increasing BMI were inversely associated with tobacco smoking. Those aged  50 and above, Hindu by religion, scheduled caste and tribes, and rural residents were more significantly associated with alcohol–tobacco use than their counterparts.

A high prevalence of tobacco and alcohol use exists in the older population in India, including those with DM or HTN morbidities. This accentuates their risk of further disease progression. Training and sensitization of medical practitioners towards regular assessment, and actively supporting tobacco and alcohol cessation, especially in those having chronic disease morbidity, are urgently warranted.