Socioeconomic causes behind alcohol and tobacco consumption in North-East India in comparison with other states of India

The North East (NE) region of India shows much higher rates of alcohol and tobacco usage compared to the national average, particularly among women. States like Arunachal Pradesh, Manipur, Sikkim, Tripura, Meghalaya, Mizoram, and Assam consistently report high usage. Lower educational levels are associated with greater use, particularly among middle-aged individuals. Still, in some NE states, higher female literacy may also reflect greater social acceptance of alcohol among women. Poverty and low socioeconomic status lead to higher spending on alcohol and tobacco, with poorer and unemployed people often spending a larger share of their income on these products. Higher SES is sometimes linked to more frequent, but smaller, drinking; lower SES groups tend to consume larger amounts, often to cope with stress. Manual laborers, unemployed people, and Scheduled Tribe populations in the Northeast use more resources, influenced by cultural and social norms. Family habits and peer influence also raise the likelihood of use. More liberal social norms and workforce participation contribute to higher rates among NE women, and widowed, separated, or divorced women are at greater risk. Alcohol and tobacco use are closely linked. Using one raises the chances of using the other. Spending on these products often comes at the expense of healthcare, food, and education, worsening poverty and health outcomes. Socioeconomic factors such as education, occupation, income, social norms, and culture shape alcohol and tobacco use in NE India. Targeted public health efforts are needed for high-risk groups. This paper aims to estimate the impact of these factors in the Northeastern states.