Risk factors associated with tobacco habits among adolescents: A cross-sectional school-based study.

Background. The increase in tobacco use among adolescents in India is fraught with serious public health implications. The knowledge of factors which influence this habit could assist in tackling this problem. Hence, we aimed to determine factors associated with tobacco use among school students. Methods. Data on determinants of tobacco use were collected from 4786 students of classes VII to XII (age 11– 19 years) studying in the schools of Noida city, using a selfadministered questionnaire. A cluster sample design was used to produce a representative sample of schools. The classes were randomly selected and from each selected class, all students of every alternate section were included. Differences in proportions between the various groups were tested using Pearson chi-square test or Fisher exact test. Results. Of the 4786 students, ‘current tobacco use’ was reported by 197 (4.1%) students; 107 (2.2%) were exclusive smokers, 49 (1%) were exclusive tobacco chewers and 41 (0.9%) used both forms of tobacco. Tobacco use was less frequent among children of white collar than blue collar fathers (p<0.05) and also among children of more educated than less educated mothers (p<0.05). Tobacco use of father, mother, siblings and friends had a significant association with the student’s tobacco use. The habits were 10.6-, 6.4-, 3.1- fold higher among students if they bought tobacco for teachers, brothers, father/relatives, respectively. Among tobacco users, 31.5% adopted these habits to refresh themselves, 45.9% preferred smoking outside home and 61% were influenced by actors smoking in films. Conclusions. Socioeconomic status, family and peer influence play an important role in students using tobacco.

Age at initiation & prevalence of tobacco use among school children in Noida, India: A cross-sectional questionnaire based survey.

Background & objectives: Tobacco use among school children is becoming a serious problem in developing countries. The early age of initiation underscores the urgent need to intervene and protect this vulnerable group from falling prey to this addiction. The present study was thus undertaken to assess the prevalence of tobacco habits among school children, determine the age of initiation of these habits, and compare the age of initiation between students who were more than 15 and ≤ 15 yr of age. Methods: Data on tobacco use were collected from 4786 students of class 7 to 12 (age: 11-19 yr) studying in different private and government schools of Noida city during July- December 2005, through cluster and random sampling using a self-administered questionnaire. Results: Any kind of tobacco use was found in 537 (11.2%) students; 419 (8.8%) were ‘ever smokers (including current smokers)’ 219 (4.6%) were ‘ever tobacco chewers (including current chewers)’, 179 (3.7%) were ‘exclusive smokers’ and 118 (2.5%) were ‘exclusive tobacco chewers’. The mean age of initiation of these habits was around 12.4 yr. More than 50 per cent of tobacco chewers reported use of khaini at least once. Nearly 70 per cent of boys and 80 per cent of girls ≤ 15 yr initiated the habit of tobacco before the age of 11 yr. A significant early uptake of tobacco chewing was reported from private school students as compared to government school students (P<0.05). Interpretation & conclusions: Tobacco addiction is emerging as a big threat among children. Our findings indicate a recent downward shift in the age at initiation of tobacco uptake and rising prevalence among girls. Such data need to be collected from different parts of the country to develop anti-tobacco campaigns and take policy decision.