# 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.

## Key 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.