Gender Disparities in Tobacco, Alcohol Consumption and Dietary Diversity Among Indian Adults (15-49): Insights from the National Family Health Survey (NFHS-5) 2019-21

Background Understanding gender-specific health behaviors is crucial for assessing mortality risk factors. In India, the paucity of data has hindered research in this area. This study fills this gap by investigating gender differences in smoking, alcohol consumption, and diversified dietary habits among Indian adults. This study further explored the differences in gender-specific health behaviors among rural urban areas. Methods Using data from the National Family Health Surveys (NFHS-5) 2019-21, we analyzed individuals aged 15–49 years via bivariate and multivariate statistical techniques. We carried out binary logistic regression to assess the likelihood of engaging in these behaviors on the basis of gender and other socioeconomic factors. Results According to the NFHS-5 data, tobacco use is substantially greater among men (42.19%) than among women (6.5%), and alcohol consumption is also more prevalent among men (25.43%) than among women (1.87%). Men demonstrate greater dietary diversity, with 28.25% consuming diverse foods, whereas 23.6% of women do so. Gender dynamics remain consistent when differences by rural and urban residence are analyzed. However, rural men consume more alcohol and tobacco substances than their urban counterparts do (34.3% vs. 31.2%), whereas rural women have lower dietary diversity than urban women do (21.3% vs. 30.7%). Notably, the use of smokeless tobacco among women (5.53%) exceeds that of smokers (0.52%), with this difference being more pronounced in rural areas. Conclusion This study highlights significant gender disparities in health behaviors among Indian adults. Men are more likely to consume substances such as alcohol and tobacco (25.6 times higher, 95% CI: 24.29 26.12) but have better dietary diversity (1.34 times higher, 95% CI: 1.31 1.37) than women. Rural areas are disadvantaged in terms of a higher prevalence of consuming these substances, especially in men, and a lower percentage of people eat diverse diets, especially women, whereas urban areas present relative advantages. Targeted, gender-specific health interventions are needed, particularly in rural settings, to address these disparities and promote healthier lifestyles.