Background: The initiation of tobacco addiction is complex, and several factors contribute to the onset of this behavior. It is presumed that the influence of family environment may pose a key factor in tobacco addiction. Tobacco-use has been highly observed in the Jamnagar district of Saurashtra region of Gujarat, India. No earlier study has focused on determining the pervasiveness of tobacco-use in families of tobacco users and non-users in this geographical area. Thus, this study aimed to assess the practice and pattern of tobacco-use (smoking and/or tobacco-chewing) in the families of tobacco-user patients. Methods: We studied the families of 65 tobacco-user patients (Group 1) who visited an outpatient clinic of an Ayurvedic post-graduate hospital with complaints of cough were studied and compared with age and gender-matched non-tobacco users (Group 2). The prevalence of tobacco use among the parents, siblings, and children of both groups was analyzed and compared. Results: The findings revealed that tobacco use among parents, siblings, and children in Group 1 was higher than Group 2 (p < 0.001). This meant that the problems of tobacco addiction are not always related to the individual, and therefore, tobacco-prevention strategies should focus on the entire family. Conclusions: These findings offer further insight into the promotion of smoking prevention interventions. Nevertheless, further research is warranted.

Department of Chemistry Faculty of Science University of Hradec Králové 50003 Hradec Králové Czech Republic

Department of Education University of Catania 2 Ofelia 95124 Catania Italy Center of Excellence for the Acceleration of Harm Reduction University of Catania 95123 Catania Italy

Department of Rasashastra and Bhaishajya Kalpana All India Institute of Ayurveda New Delhi 110076 India

Faculty of Medicine University of Porto Alameda Prof Hernani Monteiro 4200 319 Porto Portugal Institute for Research and Innovation in Health University of Porto 4200 135 Porto Portugal

Institute of Medical Sciences Department of Medicinal Chemistry Faculty of Ayurveda Banaras Hindu University 221005 Varanasi India

Institute of Medical Sciences Department of Rasashastra and Bhaishajya Kalpana Faculty of Ayurveda Banaras Hindu University Varanasi 221005 India

National Institute of Indian Medical Heritage CCRAS Ministry of AYUSH Government of India Hyderabad Telangana 500036 India

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