State of Smoking in India | Foundation for a Smoke-Free World

state of smoking in india

This page was last edited on: July 13, 2022 at 9:18 am

smoking rate

tobacco use rate

Tobacco Use and Trends

  • There are 267 million tobacco users in India, making it the country with the second largest number of tobacco users in the world (behind China).
  • Approximately 100 million people ages 15 and older currently smoke tobacco (cigarettes and bidis).
  • Approximately 200 million people ages 15 and older use smokeless tobacco.
  • Tobacco use is higher in rural areas, among those with a lower socioeconomic status, and among those with lower levels of education.
  • Tobacco use prevalence is also significantly higher among men (42.4%) versus women (14.2%).
  • There is substantial variation in the prevalence of tobacco use by state, ranging from 9.7% in the southern state of Goa to 64.5% in the northeastern state of Tripura.

Table 1: Tobacco use prevalence in india

Source: GATS 2016-17

Health and Economic Burden From Tobacco Use

  • Tobacco is estimated to account for more than 1.2 million deaths.
  • India accounts for nearly three-quarters of the global burden of disease attributable to smokeless tobacco. Notably, more than 350,000 deaths annually are associated with smokeless tobacco use.
  • Various forms of tobacco use are responsible for an estimated 27% of all cancers in India in 2020.
  • Tobacco causes a substantial economic burden. Total economic costs attributable to all diseases and deaths in India in 2018-2019 for those above 35 years was USD 27.5 billion. Smoking contributed 74% and SLT use contributed 26% of the costs.


  • Nearly 9 in 10 doctors in India mistakenly believe that nicotine causes lung cancer
  • On average, 80% of the physicians incorrectly believe nicotine causes COPD, birth defects and a range of cancers.
  • While on average 94% of doctors in India at least moderately agree that helping patients quit smoking is a priority, lack of training and nicotine knowledge adversely impacts quitting and harm reduction advice.
  • Nearly half (48%) of doctors say they are not appropriately trained to help patients quit smoking.

The Doctors’ Survey, which was funded by a Foundation for a Smoke-Free World grant, was conducted in 2022 by Sermo who surveyed more than 15,000 physicians in 11 countries, including India. To learn more about the Doctor’s Survey findings in India, click here.

regulatory environment

  • India signed and ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) in 2004, thereby affirming its commitment to use the WHO’s MPOWER measures to curb tobacco use.
  • In that vein, the country was considered to have met targets to establish health warnings on cigarette packs and develop cessation programs and scored ‘moderately’ for monitoring of prevalence data, advertising bans, developing smoke-free environments and taxation. In 2020, tax-inclusive retail sales price for a pack of 20 most popular brand was INR 190 — 57.6% of the price was tax (total tax including excise, sales and the National Calamity Contingent Duty (NCCD)).
  • In 2011, India banned food products containing nicotine (e.g., gutkha), however a substantial number of people continue to use such products.
  • Tobacco harm reduction products such as e-cigarettes and heated tobacco products face a nationwide government ban.


  • In addition to being a major consumer of tobacco, India is second largest producer of tobacco in the world producing 761,335 tons, with the vast majority of tobacco production concentrated in three states and employing nearly 25 million across the production value chain.
  • The Indian Ministry of Agriculture, Cooperation, and Farmers Welfare implemented a Crop Diversification Scheme, part of the Rashtriya Krishi Vikas Yojna program, in states with high levels of tobacco production. The government reported in 2018 67,512 hectares or 8.7% of land in the designated area has been diversified away from tobacco since 2015-2016.

As research findings become available that are inclusive of additional gender identities, the Foundation will update the information presented. 

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