New Delhi: Every third adult in rural areas and every fifth adult in urban areas uses tobacco in some form or the other, revealed the Global Adult Tobacco Survey 2 (GATS 2), released by the ministry of health and family welfare on Wednesday.

The survey revealed that 28.6% (266.8 million) of adults—aged 15 and above— in India currently use tobacco in some form. Among the adults 24.9% (232.4 million) are daily tobacco users and 3.7% (34.4 million) are occasional users.

The most commonly used tobacco product in India is khaini, a tobacco, lime mixture, that is used by every ninth adult (11.2%). The next most commonly used tobacco product is beedi, smoked by 7.7% of adult Indians. Gutkha, a tobacco, lime, areca nut mixture, ranks third (6.8%) and betel quid with tobacco ranks fourth (5.8%). The prevalence of tobacco use among men is 42.4%, while among women it is 14.2%, according to the survey.

The GATS 2 report showed that every tenth adult in India smokes tobacco—11.9% in rural areas and 8.3% in urban areas. The prevalence of smoking among men is 19.0%, while among women the figure is 2.0%.

The survey also showed that second-hand smoke is gradually becoming a major cause of concern in India.

More than one-third (35%) of non-smokers were exposed to second-hand smoke (SHS) at home. In urban areas 25% of non-smokers and in rural areas 40.4% of non-smokers were exposed to SHS at home, respectively.

Tobacco use is a leading cause of premature, non communicable diseases associated mortality and morbidity, and a growing public health challenge. While many people are aware that tobacco use increases the risk of cancer, there are alarming gaps in knowledge of the cardiovascular risks of tobacco use. According to the World Health Organization, more than half of adult Indians did not know smoking can cause stroke.

“The tobacco epidemic is a major public health challenge in India, and flavored smokeless tobacco usage in India is very high. Concerted strong political commitment and targeted action over the last decade have contributed to commendable achievements in pushing back the tobacco epidemic," Anupriya Patel, minister of state, health and family welfare said.

GATS 2 was carried out in all the 30 states of India and in the two union territories of Chandigarh and Puducherry from August 2016 to February 2017. The analysis is based on 74,037 completed interviews, among which 33,772 were with men and 40,265 with women. Of these, 47,549 interviews were conducted in rural areas and 26,488 in urban areas.