For older adults in North-eastern India, tobacco and alcohol are not just habits carried into later life. This study finds they are closely tied to several chronic illnesses, with one especially striking link to cancer. The North-eastern region of India has a relatively higher prevalence of substance use.

Together with poor dietary practices and a lack of physical activity, this is one of the key risk factors for long-term diseases among older adults in the region. Understanding the prevalence of long-term diseases and their relationship to substance use can help develop preventive strategies and awareness in North-eastern India.

The study set out to assess how common long-term diseases are among older adults in the North-eastern states of India, and how strongly substance use is linked with those diseases, to support prevention. That question matters because prevention depends on knowing both how widespread illness is and which everyday behaviours are connected with it.

The study used information from a nationwide ageing study to assess long-term diseases and substance use among older adults in the North-eastern states of India. The wider project gathers information about older people’s social, economic, and health circumstances so policymakers can improve health and health behaviours.

The study treated each non-communicable disease as a binary outcome, recorded simply as yes or no, rather than on a graded scale. It then used binary logistic regression to identify significant relationships between ever-consumed substances and non-communicable diseases in this study.

The comparisons also took account of social, economic, and demographic differences, so the relationship was not treated as if those background factors did not matter. The share of older adults with at least one long-term disease differed sharply across the region.

Sikkim had the highest share, while Nagaland had the lowest. The state-level figures show that the burden of non-communicable disease varies across the North-eastern states, with Sikkim highest and Nagaland lowest. Among older adults in north-eastern India, chronic diseases affect a markedly different share depending on where people live: about two-thirds in Sikkim, compared with just over one-fifth in Nagaland.

That gap points to major differences in health needs across neighbouring states. Alcohol use was linked with higher chances of hypertension, diabetes, heart disease, bone and joint disease, stroke, and mental or neurological disease than never drinking.

The reported links were not all the same size: the strongest alcohol-related association in this sentence was with diabetes, followed by stroke. But the study found links, not proof that substance use caused these diseases.

Because only the first round of information was available, the study acts like a snapshot rather than a record of what happened over time. Both the chronic-disease information and the substance-use information came from participants’ self-reports, rather than independent clinical measurements available in the study.

The study also lacked data on the quantity, frequency, and duration of smoking, substance use, and alcohol consumption for each participant. The study concludes that substance use is highly associated with long-term diseases among older adults in the North-eastern region. It also reports high tobacco and alcohol use among older people living with chronic illnesses such as heart and lung disease and diabetes.

That is the practical opening: the study calls for reducing alcohol use, helping people stop smoking, and supporting physical activity in public health. Older people with chronic illness may still consume tobacco and alcohol at high levels, and some research suggests older adults can be more resistant to quitting.

Because these behaviours are modifiable, the findings have implications for health policy and may help guide effective programmes for older adults. The study points to a practical opportunity: helping older adults reduce tobacco and alcohol use, while supporting physical activity, could become an important part of improving health across the region.