Unveiling the socio contextual triggers of smokeless tobacco use among blue collar workers: implications for workplace health and policy.

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.