Rural Telangana records the second-highest spending in the country on pan, tobacco, and intoxicants, behind only the small state of Sikkim, while urban Telangana ranks just below the Northeastern states in expenditure.
Published Mar 04, 2025 | 7:00 AM ⚊ Updated Mar 04, 2025 | 7:00 AM
Synopsis: Telangana leads South India in spending on pan, tobacco, and intoxicants, with rural areas allocating 7.29 percent of household budgets to these substances – nearly double the national rural average – while urban expenditure also ranks among the highest in the country. The high consumption rates, contribute to severe public health concerns, exacerbating risks of non-communicable diseases and economic strain on households.
Telangana tops South India in spending on pan, tobacco, and intoxicants, outstripping its regional neighbours by a significant margin, recent findings from the 2023-24 Household Consumption Expenditure Survey (HCES) show.
While rural Telangana records the second-highest spending in the country on these products, only behind the small state of Sikkim, urban Telangana ranks just below the northeastern states in terms of expenditure.
The HCES data reveals that in rural Telangana, 7.29 percent of total household expenditure is allocated to pan, tobacco, and intoxicants, making it the second-highest state in India.
In urban Telangana, the percentage stands at 3.57 percent, ranking just behind states in the Northeast that have historically shown high consumption rates of these substances.
This disturbing pattern is reinforced by data from the National Family Health Survey-5 (NFHS-5), which reveals exceptionally high rates of tobacco and alcohol use across the state, particularly in rural areas.
This high expenditure on tobacco and intoxicants in Telangana raises significant concerns regarding public health.
Tobacco use is a major risk factor for several non-communicable diseases, including cancer, cardiovascular diseases, and respiratory conditions.
Higher consumption rates often correlate with increased health burdens and economic strain on households due to medical expenses and lost productivity.
The HCES report offers a sobering glimpse into household spending habits in Telangana. In rural areas, households allocate an average of ₹396.06 per capita per month to pan, tobacco, and intoxicants – by far the highest among South India’s five states.
Urban households follow closely, spending ₹320.73 per capita, also the highest in the region.
This expenditure translates to 7.29 percent of total household budgets in rural Telangana and 3.57 percent in urban areas, dwarfing the national averages of 3.84 percent (rural) and 2.37 percent (urban).
For context, consider how Telangana’s figures stack up against its South Indian counterparts:
Telangana’s rural households spend nearly five times more on these items than Kerala’s, and even in urban areas, the state’s expenditure exceeds Karnataka’s, the next highest, by a substantial margin.
Across most South Indian states, rural spending outpaces urban spending – a pattern Telangana exemplifies dramatically – except in Karnataka, where urban consumption takes a slight lead.
Across Telangana, 5.6 percent of women and 22.3 percent of men use tobacco – rates that rank among the highest in South India, surpassed only by Karnataka in certain categories. But the rural-urban divide is stark:
Nationally, NFHS-5 reports that 38 percent of men and 9 percent of women aged 15 and over use tobacco, with rural areas (43 percent for men, 11 percent for women) outpacing urban areas (29 percent for men, 6 percent for women).
Telangana’s rural numbers exceed these national benchmarks, reflecting an intensified problem.
Education and wealth also influence tobacco use. NFHS-5 notes a steady decline in usage with increasing education – 58 percent of men and 15 percent of women with little or no schooling use tobacco, compared to 18 percent of highly educated men.
Wealth follows a similar pattern: 58 percent of men in the lowest wealth quintile use tobacco, versus 21 percent in the highest.
In Telangana, these socio-economic factors likely exacerbate rural consumption, where poverty and limited education are more prevalent.
Alcohol use in Telangana paints an even grimmer picture through NFHS-5. The state leads South India in alcohol consumption among both genders:
Among women, Telangana’s 6.7 percent rate is high compared to the national average of 1 percent, though it falls short of states like Arunachal Pradesh (24 percent) and Sikkim (16 percent).
For men, Telangana’s 43 percent ties it with Arunachal Pradesh (53 percent) as one of India’s highest, dwarfing the national figure of 19 percent. The rural-urban disparity mirrors tobacco trends, with rural areas bearing the brunt of this epidemic.
Dr. Sudhir Kumar, a Neurologist at Apollo Hospital in Hyderabad, attributes this surge to accessibility. “The primary reason for Telangana’s high expenditure on intoxicants is their widespread availability,” he told South First.
Reflecting on two decades in Hyderabad, he recalls a shift in policy: “During the YSR(Rajashekar Reddy) government, there was little promotion of alcohol. But after KCR (K Chandrashekar Rao) took office, liquor licenses surged, and today, nearly every street has an alcohol shop.”
Dr. Kumar points to the commercialisation of alcohol as a key driver.
“We now have malls dedicated to alcohol sales. A three-story liquor mall attracts luxury cars like BMWs and Mercedes,” he adds. “This prominence sends a message – especially to the young – that alcohol is not just normal but desirable.”
He recounts a personal anecdote: “My daughter once asked, ‘It must be something good if there are malls for it now.’”
The economic fallout of this spending is profound. In rural Telangana, where 7.29 percent of household budgets go to intoxicants, families sacrifice essentials, deepening poverty cycles.
“Many poor families spend on cigarettes and alcohol, leading to financial ruin,” Dr. Kumar notes. “A husband addicted to alcohol often squanders his wife’s earnings – money meant for food or education.”
Socially, the consequences are devastating. “Alcohol is often at the center of domestic violence and family breakdowns,” Dr. Kumar explains.
“In many cases, husbands die in their 40s from alcohol-related illnesses, leaving wives as sole breadwinners.” The healthcare burden is equally crippling – studies show that costs from treating tobacco- and alcohol-related diseases far outstrip tax revenues from these products.
“The government loses money in the long run,” he asserts.
Nationally, spending on pan, tobacco, and intoxicants has climbed over two decades.
Rural India’s share rose from 2.87 percent in 1999-2000 to 3.84 percent in 2023-24 – a 34 percent increase – while urban areas saw a U-shaped trend, dipping to 1.53 percent in 2009-10 before climbing to 2.37 percent.
Telangana’s figures, however, consistently exceed these averages, with rural spending nearly double the national rural rate.
The rural-urban gap has widened over time, particularly in Telangana, where rural expenditure has surged.
This trend reflects broader socio-economic shifts, including increased availability and cultural normalisation of intoxicants, especially in rural communities.
Dr. Kumar critiques government policies that fuel this crisis. “When the government issues licenses and promotes alcohol availability, it signals acceptability,” he says.
He recalls the COVID-19 lockdown: “When people were dying, the first thing reopened was liquor stores. It shows their priorities.”
Beyond policy, he faults societal influences. “Celebrities endorse alcohol and tobacco, outweighing health experts’ warnings. If a superstar promotes it, millions believe it’s fine.”
He calls for stricter regulations on endorsements: “Celebrities profit at public health’s expense. Their influence must be curbed.”
Addressing this crisis requires more than bans, which Dr. Kumar deems impractical.
“No government has fully banned alcohol or tobacco – black markets would thrive,” he says, citing Bihar’s failed prohibition. Instead, he advocates a multi-pronged strategy:
“The cycle of spending, sickness, and premature death must be broken at a policy level,” he urges.
“People spend on alcohol and tobacco, fall ill, and spend more on treatment. Many die early. This is preventable.”
(Edited by Dese Gowda)
