Abstract
<title>Abstract</title> <p> <bold>Objective</bold> Gallbladder cancer (GBC) is a rare but highly fatal malignancy due to late diagnosis. Tobacco use is common in India and linked to several cancers. This study examines association of tobacco with GBC risk in the Indian population. <bold>Methods</bold> A multicentre hospital-based case–control study including 2,103 histopathologically confirmed GBC cases and 6,802 visitor controls was conducted. Detailed information on tobacco habits was collected. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between tobacco use, duration and age at initiation, and GBC risk, stratified by sex. The reference group comprised of “non-tobacco users”. Important confounders such as demographic factors, height, alcohol consumption and self-reported gallstone history were adjusted. <bold>Results</bold> Use of tobacco in any form increased the risk of GBC by 46% to 64%. The risk was higher with younger age at initiation (65%) and longer duration of tobacco use (67%). Smoking increased risk of GBC by 51%, the risk was stronger among females. Chewing tobacco was found to be positively associated with GBC risk, ranging from 56–59% higher risk. <bold>Conclusion</bold> Tobacco use may be positively associated with GBC risk in the Indian population, particularly among females. Raising awareness about tobacco use as a possible modifiable risk factor is essential and may contribute to reducing the burden of GBC. </p>