Exploring Substance Use Patterns Among Women in India: A Social Network Analysis using NFHS-5 Data

Aravinth Kr (), Thilagavathi Ramamoorthy () and Bagavandas Mappillairaju ()
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Aravinth Kr: SRM Institute of Science and Technology
Thilagavathi Ramamoorthy: National Centre for Disease Informatics and Research
Bagavandas Mappillairaju: SRM Institute of Science and Technology

Sankhya B: The Indian Journal of Statistics, 2025, vol. 87, issue 1, No 13, 346-366

Abstract: Abstract Tobacco use and alcohol consumption are recognised as major causes of early death worldwide, with significant effects on women’s reproductive health and economic stability. Understanding the patterns of substance use among women in India is crucial for designing effective public health interventions. This study uses Social Network Analysis (SNA) to explore the relationships between different tobacco products and alcohol to identify key products that could be targeted to reduce overall usage. This study utilized data from the Fifth National Family Health Survey (NFHS-5) conducted between 2019 and 2021, which included women aged 15-49 years. The sample consisted of 52,855 women who reported using at least one tobacco product or alcohol. Social Network Analysis (SNA) was used to map the connections between 11 substances, including cigarettes, bidis, pipe, cigars, hookah, chewing tobacco, snuff, gutkha, khaini, paan with tobacco, and alcohol. Social network centrality measures, such as weighted degree, closeness, betweenness, and eigenvector centrality, were calculated to identify the most influential products in the network. The most commonly used substances were paan with tobacco (31.2%), alcohol (25.6%), and gutkha (25.3%). Alcohol emerged as the most central product in the network, indicating its strong connection to other tobacco products. Paan with tobacco and gutkha were also highly central, showing their frequent co-use with other products. Targeting alcohol and smokeless tobacco products like paan with tobacco and gutkha in public health interventions could have a widespread effect on reducing overall tobacco use. Reducing alcohol consumption could significantly disrupt the co-use of tobacco products, leading to more effective strategies for tobacco cessation among women in India.

Keywords: Social network analysis; Tobacco use; Alcohol consumption; Co-occurrence (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s13571-025-00354-2

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