Table 4 Nested multilevel regression of tobacco consumption (any, smoking, smokeless tobacco and both) among middle aged and elderly Indian adults with various demographic, socioeconomic, health related and behavioural determinants (* p-value < 0.05)

Age group (years)

45–59 (middle aged)

Reference

Reference

Reference

Reference

 > 60 (elderly)

1.23 (1.18–1.28)*

1.99 (1.14–1.27)*

1.08 (1.03–1.14)*

1.27 (1.14–1.40)*

Gender

Male

Reference

Reference

Reference

Reference

Female

0.23 (0.22–0.24)*

0.11 (0.10–0.12)*

0.80 (0.76–0.84)*

0.14 (0.12–0.16)*

Demographic and socioeconomic factors

Religion

Hindu

Reference

Reference

Reference

Reference

Muslim

1.76 (1.66–1.86)*

1.47 (1.36–1.59)*

1.44 (1.34–1.54)*

1.90 (1.62–2.22)*

Christian

0.59 (0.55–0.64)*

1.18 (1.07–1.31)*

0.44 (0.40–0.49)*

1.17 (0.98–1.39)

Others

0.30 (0.27–0.33)*

0.22 (0.19–0.25)*

0.65 (0.58–0.73)*

0.78 (0.61–0.98)*

Caste

Schedule caste

Reference

Reference

Reference

Reference

Schedule tribe

0.78 (0.73–0.84)*

0.76 (0.68–0.81)*

0.97 (0.90–1.04)

0.94 (0.80–1.11)

OBC

0.70 (0.66–0.74)*

0.75 (0.72–0.83)*

0.82 (0.77–0.87)*

0.86 (0.75–0.99)*

Others

0.76 (0.72–0.81)*

0.88 (0.82–0.95)*

0.82 (0.76–0.87)*

0.94 (0.81–1.10)

Wealth index

Richest

Reference

Reference

Reference

Reference

Richer

1.09 (1.04–1.18)*

1.14 (1.06–1.23)*

0.93 (0.87–0.99)*

0.91 (0.78–1.05)

Middle

1.10 (1.04–1.17)*

1.19 (1.10–1.29)*

0.83 (0.7–0.89)*

1.18 (1.02–1.36)*

Poorer

1.12 (1.04–1.19)*

1.21 (1.12–1.31)*

0.94 (0.88–1.01)

1.31 (1.13–1.51)*

Poorest

1.01 (0.93–1.05)

1.15 (1.06–1.25)*

1.05 (0.98–1.12)

1.37 (1.17–1.60)*

Education

Illiterate

Reference

Reference

Reference

Reference

Less than primary

0.91 (0.81–0.99)*

0.93 (0.86–1.01)

1.04 (0.98–1.13)

1.03 (0.96–1.18)

Primary completed

0.87 (0.82–0.92)*

0.72 (0.67–0.77)*

1.02 (0.99–1.12)

1.05 (0.92–1.20)

Middle completed

0.78 (0.73–0.84)*

0.69 (0.64–0.75)*

0.98 (0.91–1.06)

0.95 (0.81–1.11)

Secondary school

0.51 (0.48–56)*

0.47 (0.43–0.52)*

0.86 (0.79–0.94)*

0.69 (0.57–0.83)*

Higher secondary

0.45 (0.41–0.49)*

0.44 (0.38–0.50)*

0.82 (0.73–0.93)*

0.51 (0.39–0.67)*

Diploma/ Graduate

0.31 (0.28–0.35)*

0.33 (0.29–0.38)*

0.59 (0.52–0.67)*

0.49 (0.37–0.63)*

Marital status

Unmarried

Reference

Reference

Reference

Reference

Married/ in live -in

1.03 (0.86–1.22)

0.96 (0.77–1.20)

1.13 (0.92–1.39)

0.81 (0.56–1.19)*

Widow/ separated/ divorced

1.34 (1.12–1.60)*

0.99 (0.79–1.24)

1.56 (1.27–1.92)*

0.97 (0.66–1.43)

Residence

Rural

Reference

Reference

Reference

Reference

Urban

0.72 (0.69–0.76)*

0.82 (0.78–0.87)*

0.77 (0.73–0.81)*

0.76 (0.68–0.86)*

Health Insurance

No

Reference

Reference

Reference

Reference

Yes

0.96 (0.85–1.10)

1.01 (0.87–1.18)

1.01 (0.86–1.18)

0.89 (0.66–1.21)

Occupation

Unemployed

Reference

Reference

Reference

Reference

Professional and semi-professional

1.05 (0.92–1.20)

0.93 (0.79–1.11)

1.12 (0.94–1.32)

1.18 (0.85–1.64)

Clerical and skilled

1.32 (1.25–1.39)*

1.05 (0.99–1.13)

1.37 (1.29–1.45)*

1.22 (1.07–1.38)*

Unskilled

1.26 (1.20–1.33)*

1.12 (1.04–1.09)*

1.24 (1.16–1.32)*

1.16 (1.02–1.33)*

Living alone

No

Reference

Reference

Reference

Reference

Yes

0.95 (0.86–1.07)

0.93 (0.79–1.09)

1.02 (0.91–1.15)

0.71 (0.51–1.02)

Region

North

Reference

Reference

Reference

Reference

Central

1.36 (1.27–1.46)*

0.40 (0.37–0.44)*

4.51 (4.09–5.00)*

2.60 (2.12–3.19)*

East

1.81 (1.70–1.93)*

0.20 (0.19–0.22)*

7.53 (6.85–8.28)*

4.39 (3.66–5.26)*

Northeast

2.56 (2.37–2.76)*

0.43 (0.39–0.48)*

7.56 (6.82–8.38)*

4.67 (3.84–5.66)*

West

1.13 (1.05–1.21)*

0.25 (0.23–0.27)*

5.33 (4.82–5.89)*

1.59 (1.27–1.98)*

South

0.65 (0.61–0.69)*

0.37 (0.34–0.40)*

2.16 (1.95–2.39)*

0.79 (0.64–0.99)*

Health related factors

Physical activity

Everyday

Reference

Reference

Reference

Reference

More than once / week

1.11 (1.06–1.17)*

0.95 (0.84–1.10)

1.17 (1.12–1.25)*

1.01 (0.90–1.13)

Once / week

1.13 (1.05–1.22)*

1.02 (0.93–1.11)

1.09 (1.01–1.19)*

1.08 (0.92–1.27)

1–3 times /month

1.20 (1.09–1.33)*

0.98 (0.86–1.11)

1.17 (1.05–1.31)*

1.24 (1.01–1.54)*

Never

1.22 (1.12–1.33)*

1.13 (1.02–1.26)*

1.18 (1.07–1.30)*

0.97 (0.78–1.19)

Self-rated health

Excellent

Reference

Reference

Reference

Reference

Very good

0.97 (0.88–1.08)

0.97 (0.84–1.10)

0.99 (0.88–1.12)

1.00 (0.76–1.32)

Good

1.00 (0.91–1.11)

1.00 (0.88–1.14)

1.00 (0.89–1.12)

0.98 (0.75–1.27)

Fair

1.34 (1.21–1.49)*

1.36 (1.20–1.56)*

1.13 (1.01–1.27)*

1.08 (0.82–1.41)

Poor

1.61 (1.44–1.81)*

1.53 (1.33–1.77)*

1.22 (1.07–1.39)*

1.54 (1.15–2.05)*

Comorbidity

No

Reference

Reference

Reference

Reference

Yes

1.04 (0.98–1.10)

1.06 (0.99–1.14)

1.03 (0.97–1.10)

0.90 (0.79–1.03)

Multimorbidity

No

Reference

Reference

Reference

Reference

Yes

1.12 (1.05–1.19)*

1.05 (0.97–1.13)*

1.07 (1.01–1.15)*

1.15 (0.99–1.35)

Behavioural factors

Alcohol consumption

No

Reference

Reference

Reference

Reference

Yes

4.94 (4.69–5.21)*

2.52 (2.38–2.68)*

1.85 (1.74–1.95)*

1.27 (1.15–1.41)*

Media Exposure

No

Reference

Reference

Reference

Reference

Yes

0.89 (0.86–0.93)*

0.92 (0.87–0.96)*

0.92 (0.87–0.96)*

0.94 (0.86–1.03)

Pseudo R²

0.2272

0.2202

0.1062

0.2095

LL

−33,215.3

−21,443.4

−27,773.1

−7491.13

LR

3901.19

1073.48

471.02

760.44

p-value

 < 0.001

 < 0.001

 < 0.001

 < 0.001

AIC

66,518.56

42,974.83

55,634.13

15,070.26

BIC

66,918.64

43,374.91

56,034.21

15,470.34

Classification accuracy

75.48%

86.09%

81.97%

96.72%