The rot in Northeast India’s substance abuse problem runs deep. A recent study shows that the prevalence of any type of substance abuse - smoking, smokeless tobacco products, alcohol - in men in Northeastern states is much higher (20 percent more) than the rest of India.
But education and participation in activities such as sports and music can go a long way in curbing substance abuse in the region, according to study authors Nandita Saikia and Benjamin Debbarma of Jawaharlal Nehru University (JNU), New Delhi.
Saikia and Debbarma, from JNU’s Study of Regional Development, School of Social Sciences, mined data from the fourth round of the National Family Health Survey 2015–2016 (NFHS-4) to examine the prevalence and frequency of smoking, using smokeless tobacco products and alcohol consumption in 14,555 men in the 15 to 54-year age group in eight Northeast Indian states.
Substance Abuse High Even By Global Standards
“Substance use was significantly higher among the male adults of Northeast India than among those from elsewhere in the country. The percentage prevalence was 50.03 percent for India as a whole, for non-northeast states it is 50.37 percent and in the states of northeast India 70.83 percent of the men in the 15 to 54-year age group indulge in substance abuse,” Saikia told FIT.
Prevalence is the “proportion of persons in a population who have a particular disease or attribute at a specified point in time” or over a specified period of time.
Saikia said the prevalence data is high not only at the national level but also at the global level. At the same time, there is a striking variance within the northeast states. The study mapped substance abuse in men in Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim, and Tripura.
Breaking down the pattern in alcohol consumption in the Northeast Indian states, the researchers show although Assam has a lower prevalence of alcohol consumption (36.92 percent) than the rest of the states in the Northeast region, the frequency of alcohol consumption (number of occurrences) among consumers is the highest in that state.
Nationally, according to the 2019 Ministry of Social Justice and Empowerment sponsored ‘Magnitude of Substance Use in India’ report, about 14.6 percent of people (10-75-year-olds) are current users of alcohol which is about 16 crore people. Prevalence is 17 times higher among men than women, the report states.
Two northeast Indian states, Tripura and Arunachal Pradesh, are among the top five states in India with a high prevalence of alcohol use, while these two states also show a high prevalence (more than 10 percent) of alcohol use disorders, as per the report.
Another worrisome finding as documented in the current study, said co-author Benjamin Debbarma, is that about 44 percent of men aged below 19 (i.e. 15 to 19 years of age) indulge in at least one form of substance abuse-smoking, smokeless tobacco products, alcohol consumption.
In terms of youth indulging in substance abuse, previous research has also emphasised that tobacco use among 13 to 15-year-old school going students in northeast India is very high. Studies have also linked parental influence in substance abuse in youngsters.
The problem of smoking tobacco and drinking alcohol is more prevalent among underprivileged people in the northeast Indian states, according to the current study.
“The results show that social groups belonging to Scheduled Tribes have the highest probability of smoking and alcohol consumption. On the other hand, except in the case of smokeless tobacco products, education appears to be a reducing factor for substance use. Similarly, the wealthier the male youth, the more they are into smoking and drinking alcohol,” explained Debbarma.
Strict policy in control of supplying the substance is needed, iterated the authors, stressing on the imposition of more tax.
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Sports, Music, Dance to Spread the Message
However, the responsibility for the execution of a public program to curb the burden of substance use rests not just on the shoulders of the government – but will also depend on community involvement.
Effective substance control strategies need to be based on an intersectional approach with various ministries, health departments, gram panchayats, public health institutions, and civil society groups, the authors said.
“Sports or music/dance can play major roles. Once youngsters are involved in sports, they are entertained and engaged. They may find more pleasure in mountain climbing/cycling/swimming than substance use. Parents’ role is important in directing youth at a young age, but the contextual factors say the availability of sports facilities, etc is equally important. By promoting sports and music, Iceland was able to cut radically smoking, drinking and drug use among teens,” Saikia underscored.
The research builds on a previous analysis in which Saikia noticed that premature death in men aged between 15 to 59 years is the highest in Assam, the largest state of northeast India in terms of population.
“Also, the prevalence of lifestyle diseases, such as cancer, diabetes, stroke is very high in the entire northeast region. Previous studies documented the association between substance use and poor health and high mortality, Therefore we wanted to carry out a detailed study of substance use patterns and its determinants, specific to the northeast region,” added Saikia.
(Sahana Ghosh is a microbiologist-turned-journalist. She writes on science and environment and is interested in science in remote areas.)