The present analysis showed a strong association between opium use and age, occupation, marital status, religion and ethnicity in both sexes. There was a weak association in the case of education and household size. An association of sociodemographic factors with opium and other drug use has previously been reported [9, 12, 21–28]. The prevalence of opium use among men was significantly higher than among women, as previously reported by others [12, 13, 26, 29]. However, the prevalence was found to increase with age in both sexes. The prevalence of opium use among older age groups was significantly higher compared with younger age groups. Though opium use among younger subjects was recorded as low, most of the opium users started it at a young age as reflected by a mean age of initiation of 23.2 years in men and 27 years in women. Such findings were widely reported elsewhere [12, 13, 25, 30, 31]. It is possible that there was under reporting of opium use in young age respondents because of concerns of privacy [12, 26].
Though opium use was recorded in all the tribes, it was significantly higher among Khamti and Singpho tribes of this region, who were mostly Buddhist. Among the majority Tangsa tribal community, opium use was particularly high among those of Indigenous religion. In contrast, there was a low prevalence of opium use among Christians, indicating the influence of religion and the traditional culture of different tribes on their habit of opium use as discussed by others [12, 25, 32]. A decreasing prevalence of opium use with increasing level of education was observed, but the multivariate analysis showed that the effect of education was not significant. The lack of a major influence of education on opium use was possibly related to the strong hold of traditional beliefs and practices among tribal people. Occupation was also found to be an important correlate of opium use. Analysis revealed high opium use among employed and self-employed respondents, who had significantly higher MRRs compared with unemployed respondents. Employment status may be a proxy indicator of respondent income and their ability to afford opium. As the cost of opium is high, its affordability and the income of individual users were also important factors related to its use. An association between substance use and occupation and income has also been reported by others [10–12, 25, 33–35].
As mentioned earlier, only a small percentage of women (2.1%) had been using opium. As they had limited social interaction, familial influence was likely the main cause of opium use among women as in previous studies [9, 12, 22]. In contrast, previous studies showed that male opium users were mainly introduced or influenced by their friends at the initial stage of taking opium [10, 11, 23, 26]. At a later stage, they continued the habit of taking opium in their own house with the acceptance of the family. As mentioned by the family during the survey, it was accepted that they control excessive opium use and prevent social harm. However, opium use had an adverse effect on their family members, especially women or female partner. Women were initially involved in helping the men prepare the opium for smoking. Thereafter, they were encouraged to use it as a medicine for body pain and stress [10, 12]. Gradually, they were persuaded to join their husband in taking opium. Such an influence of the familial environment on substance use among the family of opioid and other illicit drug users was also reported by others [12, 25, 30].
Though the study provides useful information, it has some limitations. It was an analysis of secondary data and some categories of explanatory variables did not have an adequate number of observations to estimate the odds ratios. For instance, because of the small numbers of women in some categories, it was not possible to estimate odd ratios for the association between opium use and some independent variables.