Factors Associated with Tobacco Use in Students Attending Local Government Schools in Mumbai, India

Abstract

<br /> <strong><span style="font-size: small;">Purpose: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Factors associated with ever-use and differences between ever-users and non-users of tobacco among adolescent school students from low income families in Mumbai were assessed. </span></span><strong><span style="font-size: small;">Materials and Methods: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">A self-administered questionnaire, completed by 1918 students from grades 7, 8 and 9 in 12 schools managed by the city municipal corporation in July 2015, gathered data on socio-demographic characteristics, tobacco use and tobacco-related knowledge, attitudes and beliefs. </span></span><strong><span style="font-size: small;">Results: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">Although only 1% of respondents thought tobacco was cool, nearly 35% were unaware of associations between tobacco use and health problems. Male students were almost twice as likely </span></span><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">(OR=2.5, P <= 0.05) to have ever used tobacco compared to females and Supari (areca nut) users were eight times more likely (OR=8.99, P < 0.001) than Supari non -users. Tobacco-users were more likely to agree with statements: ‘People who use tobacco have more friends' (OR=2.8, P = 0.004), ‘Smoking relieves stress' (OR=5.6, P = 0.002) and ‘It is possible to purchase any tobacco product within 100 yards of school' (OR=10.8, P < 0.001). </span></span><strong><span style="font-size: small;">Conclusion: </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">This study highlights the gains made by tobacco prevention campaigns in that almost all students did not consider tobacco as cool or a stress reliever. However, they still need education about health consequences of tobacco-use. In addition, Supa</span></span><strong><span style="font-size: small;">ri </span></strong><span style="font-family: Times New Roman,Times New Roman; font-size: small;"><span style="font-family: Times New Roman,Times New Roman; font-size: small;">use has to be addressed in school-based tobacco prevention and cessation initiatives. Furthermore, programs must also address perceptions and norms related to peers and tobacco use and ensure active implementation of existing laws. Such integrated measures will help ensure tobacco-free spaces around schools. </span></span>