Association Between Tobacco Consumption and Caloric intake Among Adolescents: A Cross-sectional study from urban slums of Jaipur.

Abstract

Background:
Adolescents in socioeconomically disadvantaged urban settings are at heightened risk of both undernutrition and early initiation of tobacco use. Nicotine’s appetite-suppressing effects may adversely influence dietary intake, potentially exacerbating nutritional deficits in resource-constrained environments. However, empirical evidence examining this relationship in urban slum populations remains limited.

Objectives:
To assess the association between tobacco consumption and dietary intake among adolescents, and to identify predictors of caloric intake below the Recommended Dietary Allowance (RDA).

Methods:
A cross-sectional analytical study was conducted among 900 adolescents (10–19 years) residing in selected urban slum clusters of Jaipur, India. Data were collected using a structured questionnaire, anthropometric measurements, and a 7-day dietary logbook. Nutritional status was assessed using Body Mass Index (BMI), and daily caloric intake was compared against ICMR (2010) RDA guidelines. Associations were examined using Chi-square tests and correlation analysis. Multivariate logistic regression was performed to identify independent predictors of caloric intake below RDA.

Results:
Overall, 58.0% of adolescents had caloric intake below RDA. Underweight prevalence was 33.5%, while 60.4% had normal BMI and 6.0% were overweight. Tobacco use was significantly associated with inadequate caloric intake, with 75.6% of users consuming below RDA compared to 40.4% of non-users (χ² = 113.9, p < 0.001). A significant association was also observed between tobacco use and BMI category (χ² = 6.13, p = 0.047). Smokeless tobacco, particularly gutkha, was the predominant form, with a mean initiation age of 14.3 years. In multivariate analysis, tobacco consumption emerged as an independent predictor of caloric intake below RDA.

Conclusion:
Tobacco consumption is significantly associated with inadequate caloric intake and increased risk of undernutrition among adolescents in urban slums. Integrated interventions targeting both tobacco use and nutritional improvement are warranted in this vulnerable population.