Substance abuse in various forms has always been culturally and socially acceptable particularly among adult in Himachal Pradesh. Angoori (a local grape wine from Kinnaur region), moori (local apple wine from upper region of Shimla Kullu Kinnaur), Aara (famous local drink from Lahual and spiti), Chhang and lugdi are some of the different forms of alcohol beverages that are freely brewed, distributed and consumed at home without any restriction. Tobacco uses in different forms (bidi, hukkah, chilam) has been used for ages by the people of Himachal [1].

Tobacco smoking is the biggest public health threat of the current era. Worldwide, smoking‑related diseases kill an estimated 4 million people every year. This number is predicted to rise to a staggering 10 million a year over the next two decades. There is an overwhelming body of evidence of increased cancer risk in cigarette smokers [2].

According to the WHO, there are three million deaths yearly annually due to alcohol consumption, which constitutes around 5.3% of total deaths globally and 5.1% of the global burden of disability-adjusted life years (DALYs) due to alcohol consumption. The consumption of alcohol leads to various digestive or cardiovascular diseases, including cancer [3].

Legislative efforts to control substance abuse don’t look very promising either, as we can see people smoking publically, wine shops selling alcohol to minors, smokeless tobacco products being sold even after ban. Most of the bars in Shimla city allow minors to drink and smoke keeping their monetary benefits above the law [4,5].

Though not much scientific data on this problem is available still some studies has reported high level of alcohol and tobacco use among adolescent and youth in Shimla City [2,6,7].

A number of studies have done in different parts of the India to see the pattern of Smoking and Alcohol consumption; such studies are limited in hilly areas of District Shimla. Thus, the present study was developed to evaluate the pattern of Smoking and Alcohol consumption among adult population of District Shimla.

Objectives of the Study

To evaluate the pattern of Smoking and Alcohol consumption among adult population of District Shimla.

Research Methodology:

• Research Approach -Descriptive

• Research Design- Cross-sectional survey design

• Study area: District Shimla

• Study duration- between September 2021- October 2021 

• Study population-Adults population aged between 18-60 years

• Sample size-400 adults assuming 50% adults have adequate knowledge regarding Smoking and Alcohol consumption, 5% absolute error, 95% confidence level, and 5% non-response rate

• Study tool: A google form questionnaire consisting of questions regarding socio-demography and pattern of Smoking and Alcohol consumption was created. 

• Inclusive Criteria- who were willing to participate in the study

• Exclusion Criteria: who were not willing to participate in the study

• Validity of tool - by the experts in this field

Data Collection

Data was collected under the guidance of supervisors. The google form questionnaire was circulated via online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin. Responses were then recorded in a Google Excel spreadsheet, the information from which was used to generate graphical display.

Data Analysis

Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analysed with Epi Info V7 Software with appropriate statistical test in terms of frequencies, percentage, mean standard deviation etc.

Present study was developed to evaluate the pattern of Smoking and Alcohol consumption among adult population of District Shimla. A total of 400 respondents including 194(48.5%) females and 206(51.5%) males from district Shimla were participated in the study. Among the participants of the majority 189(47.3%) were in age group of 31-40 years, 159(39.8%) were in Govt Job,338(84.5%) were graduate and above, 235(58.8%) were from urban area and 387(96.8%) were belong to Hindu Religion (Table 1).

Table 1: Socio-demographic characteristics of study participants

Table 2: Pattern of smoking among study participants

Table 3: Pattern of smoking according to Gender

Table 4: Pattern of Alcohol among study participants

Table 5: Pattern of smoking according to Gender

Among the total 400 study participants, majority 45 (11.3%) were smokers. Majority of them (26) smoke daily. Most of the them (23) smoke 2 cigarettes daily on an average (Table 2).

Among the 194 females in the study, 3(1.5%) were smokers while among 206 males 42(20.4%) were smokers. So, males were significantly more smoker statistically (Table 3).

Among the total 400 study participants, majority 81 (20.3%) were alcoholic. Majority of them (46) took alcohol once weekly. Most of the them (31) took 3 pegs of alcohol on an average in one time (Table 4).

Among the 194 females in the study, 5(2.6%) were alcoholic while among 206 males 76(36.9%) were alcoholic. So, males were significantly more alcoholic statistically (Table 5).

In the present study, among the total 400 study participants, majority 45 (11.3%) were smokers. Majority of them (26) smoke daily. Most of the them (23) smoke 2 cigarettes daily on an average. Among the 194 females in the study, 3(1.5%) were smokers while among 206 males 42(20.4%) were smokers. 

Table 6: Pattern of smoking and Alcohol in District Shimla as per NFHS-5

So, males were significantly more smoker statistically. In the NFHS-5 Survey in 2019-20 in District Shimla1.5% of females and 31.7% females were using any kind of tobacco [8].

In the current study, among the total 400 study participants, majority 81 (20.3%) were alcoholic. Majority of them (46) took alcohol once weekly. Most of the them (31) took 3 pegs of alcohol on an average in one time. Among the 194 females in the study, 5(2.6%) were alcoholic while among 206 males 76(36.9%) were alcoholic. So, males were significantly more alcoholic statistically. In the NFHS-5 Survey in 2019-20 in District Shimla 0.5% of females and 34.4% females were consuming alcohol [8] (Table 6).

As smoking and alcohol are individual behavior influenced by individual and societal influences, efforts to foster positive long‑term interventions focused at the individual, family and community levels should be the focus of the program and policy makers in India as well in Himachal Pradesh. To prevent the disease burden from legal substances, abuse like alcohol and smoking, a cost-effective non-pharmacological approach is required. We recommend the detail study to understand the current scenario of substance abuse in Shimla city and to develop a comprehensive program to combat the problem.

Ethical Approval

Participants confidentiality and anonymity was maintained.

1. Kumar, D., et al. “Alcohol and other substance abuse among youth: an obvious but neglected scenario in Shimla city of Himachal Pradesh, India?” International Journal of Community Medicine and Public Health, vol. 3, 2355-2356, 2016.

2. Thakur, D., et al. “Prevalence of cigarette smoking and its predictors among school-going adolescents of North India.” South Asian Journal of Cancer, vol. 3, 193-195, 2014.

3. Sivapuram, M.S., et al. “Prevalence of alcohol and tobacco use in India and implications for COVID-19 - Niyantrita Madhumeha Bharata study projections.” Journal of Medicine and Life, vol. 13, no. 4, 499-509, 2020.

4. Himachal Watcher. “Shimla police tightens grip on drug peddlers, dealers, suppliers.” Retrieved from https://himachalwatcher.com/2016/02/04/shimlapolice-tightens-grip-on-drug-peddlers-dealerssuppliers/. (Accessed October 24, 2021).

5. The Times of India. “Courier firm owner held in drug racket.” Retrieved from http://timesofindia.indiatimes.com/city/delhi/Courier-firm-owner-held-in-drugracket/articleshowm/51665698.cms. (Accessed October 25, 2021).

6. Sharma, P., et al. “Pattern of substance abuse in patients attending psychiatry OPD of IGMC, Shimla.” IOSR Journal of Dental and Medical Sciences, vol. 13, no. 8, 853-861, 2014.

7. Kumar, D., et al. “Tobacco use and its correlates among youth in a northern urban city of India.” International Journal of Science Research, vol. 5, no. 3, 1577-1582, 2016.

8. NFHS-5 Shimla. Retrieved from http://rchiips.org/nfhs/NFHS-5_FCTS/FactSheet_HP.pdf. (Accessed October 27, 2021)