Unveiling the socio contextual triggers of smokeless tobacco use among blue collar workers: implications for workplace health and policy

TL;DR

This study explores why blue-collar workers in India use smokeless tobacco, highlighting workplace conditions and social norms as key factors.

Contribution

The study identifies specific socio-contextual triggers of smokeless tobacco use among blue-collar workers using structural equation modeling.

Findings

Working conditions significantly influence smokeless tobacco use among blue-collar workers.

Social norms and support impact smokeless tobacco use more than health knowledge.

Perceived effectiveness of tobacco control policies negatively correlates with smokeless tobacco use.

Abstract

This study investigates the socio-contextual determinants of smokeless tobacco (SLT) use among blue-collar workers in India, a demography exhibiting the world’s highest SLT use. The Social Ecology Theory is used to understand the phenomenon by analysing the data collected from 392 blue-collar workers, through the mediated moderation approach in the structural equation model. The findings indicate that working conditions (β = 0.17; p value = 0.007), social norms and support (β = 0.14; p value = 0.011), personality (β = 0.09; p value = 0.014), and perceived effectiveness of SLT control policies (β= -0.13; p value = 0.002) significantly impact the SLT use of blue collar workers. However, knowledge about the health effects of SLT use and neighborhood disadvantages did not exhibit a significant influence. The theoretical modelling helped identify direct effects and underlying pathways through which environmental and psychological variables jointly shape tobacco behavior. Despite limitations inherent in self-reported data, this research provides actionable guidance for policymakers and organizations to develop targeted public health policies and workplace strategies to reduce SLT use among blue-collar workers.

The online version contains supplementary material available at 10.1038/s41598-025-24275-2.

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