Linking Global Youth Tobacco Survey (GYTS) data to the WHO framework convention on tobacco control: the case for India.

India ratified the WHO Framework Convention on Tobacco Control (WHO FCTC) on February 27, 2005. The WHO FCTC is the world's first public health treaty that aims to promote and protect public health and reduce the devastating health and economic impacts of tobacco. Post ratification, each member state as part of general obligation has agreed to develop, implement, periodically update and review comprehensive multisectoral national tobacco control strategies, plans and programmes in accordance with this Convention and the protocols to which it is a Party. The Global Youth Tobacco Survey (GYTS) was developed to track tobacco use among young people across countries and the GYTS surveillance system intends to enhance the capacity of countries to design, implement, and evaluate tobacco control and prevention programs. The South-East Asia Region of WHO has developed the "Regional Strategy for Utilization of the GYTS" to meet this need for countries in the Region. In 2003, India has passed its national tobacco control legislation (India Tobacco Control Act [ITCA]), which includes provisions designed to reduce tobacco consumption and protect citizens from exposure to second hand smoke. Data in the GYTS (India) report can be used as a baseline measure for future evaluation of the tobacco control programs implemented by the Ministry of Health and Family Welfare, Government of India. India has to upscale some provisions of its National Law to accommodate all of the requirements of FCTC. Using determinants measured by GYTS in India, the government can monitor the impact of enforcing various provisions of the ITCA and the progress made in achieving the goals of the WHO FCTC and the Regional Strategies. Effective enforcement of the provisions of ITCA will show in the receding numbers of tobacco use prevalence figures and reduction in the expenditures associated with tobacco use in India.

Tobacco survey among youth in South India.

BACKGROUND: Smoking of cigarettes and, particularly, of "bidis" (which consist of about 0.2-0.3 gm of tobacco rolled up in the leaf of another plant (temburni) has been widespread for many decades among men in India. There have, however, been no substantial studies on the prevalence of tobacco use among youth in India. Hence a Global Youth Tobacco Survey was conducted in schools in Tamil Nadu as part of on-going Global Youth Tobacco survey in over 150 countries in the world. METHODS: The two-stage cluster sample method was used to select 100 schools with standards 8, 9 and 10 in Tamil Nadu. The survey used self administered questionnaires, which consisted of 88 multiple choice questions. RESULTS: A total of 4820 students participated (a response rate of 90.1%) in the 99 of 100 schools selected for the survey. About 10% of students aged 13-15 in Tamil Nadu had ever used tobacco. Significantly higher percentages of current tobacco users (one in three students) compared to never tobacco users thought smoking or chewing tobacco makes a boy or girl more attractive. About 3 in 4 current smokers expressed a wish to stop smoking and a similar proportion have already tried to quit the habit. About 80% of students considered using tobacco (smoking or chewing tobacco) to be harmful to their health. Only about half of the students reported that they have been taught in school the health effects of tobacco use during the year preceding the survey. Exposure to environmental tobacco smoke and pro-tobacco advertisements is high. CONCLUSIONS: The tobacco prevalence among girls is alarming. The results of the survey show the need to increase awareness about health hazards of tobacco use among students. Tobacco control programs focusing on youth are essential in order to reduce the burden of tobacco related diseases in India. Repeat surveys would help in monitoring the tobacco epidemic in the school and to evaluate the efficacy of state level tobacco control programs.

School policy and tobacco use by students in Bihar, India.

The association between school tobacco policies and tobacco use prevalence among students were examined. A two stage cluster sample design with probability proportional to the enrolment in grades VIII-X was used. Comparison was made between schools with a tobacco policy (Federal schools) and schools without a policy (State schools). Stratified probability samples of 50 schools each were selected. SUDAAN and the C-sample procedure in Epi-Info was used for statistical analysis. Students from State schools (without tobacco policy) reported significantly higher ever and current any tobacco use, current smokeless tobacco use and current smoking compared to Federal schools (with tobacco policy) both in rural and urban areas. Classroom teaching on the harmful effects of tobacco was significantly higher (17-24 times) in Federal schools than State schools both in rural and urban areas. Parental tobacco use was similar for students in Federal and State schools. Students attending state schools were more likely than students attending Federal schools to have friends who smoke or chew tobacco. These findings suggest that the wider introduction of comprehensive school policies may help to reduce adolescent tobacco use.

Servicios de salud maternoinfantil y vacunación en Panamá y Guatemala / Maternal and child health services and vaccination in Panamá and Guatemala

En Guatemañla y Panamá se efectuaron en 1983-1984 y 1984-1985, respectivamente, dos encuestas mediante entrevistas, diseñadas para evaluar la medida en que se utilizan los servicios de salud maternoinfantil. En la encuesta panameña se obtuvieron entrevistas completas de 8 240 mujeres de 15 a 49 años de edad, mientras que en la encuesta guatemalteca se realizaron entrevistas completas a 3 670 mujeres de 15 a 44 años de edad. Estas entrevistas se realizaron principalmente para estimar la prevalencia del uso de la contracepción y para proveer datos basados en la población sobre el uso de servicios de salud maternoinfantil, entre ellos los de vacunación a todos los niveles, con objeto de medir el impacto del programa en cada país. Para los propósitos de este análisis, la muestra de la encuesta en ambos países se limitó a mujeres de 15 a 44 años de edad que estuvieran casadas en el momento de la entrevista y que hubieran dado a luz un hijo vivo dentro de los cinco años anteriores. En Panamá, un porcentaje mucho mayor que en Guatemala de mujeres casadas de 15 a 44 años informaron que utilizaban los servicios de salud maternoinfantil. En ambos países, un porcentaje relativamente alto de mujeres que residían en las zonas urbanas dijeron que hacían uso de estos servicios, mientras que las mujeres indígenas de ambos países informaron que hacían un uso relativamente escaso de ellos. Además, se encontraron asociaciones entre la utilización de dichos servicios y el grado de escolaridad de la madre, su ocupación, paridad y el lugar donde tuvo a su último hijo. Asimismo, era más probable que emplearan métodos contraceptivos las mujeres que usaban los tres tipos de servicios de salud maternoinantil que las mujeres que habían dicho que utilizaban solo alguno o ninguno de ellos. En lo que se refiere al grado de cobertura de la vacunación de niños pequeños en Panamá y Guatemala, los datos de la encuesta señalaron que el grado de vacunación era relativamente mayor en Panamá...