Understanding factors which influence tobacco (smoking and smokeless) in secondary school children in Delhi (India)

Abstract

1024 Background: Study conducted to estimate the magnitude of tobacco consumption among adolescent school children in Delhi; the association of tobacco use with awareness, risk taking attitude and alcohol usage; and to understand the role of gender, age and socio-economic status. Methods: Cross sectional study of two randomly identified, co-educational schools of different socio-economic stratum. The questionnaire was pre-tested and administration was unlinked, anonymous. Apriori informed consent of all concerned was obtained. Analyzable sample size was 596. Analysis was done using SPSS ver 11. Appropriate statistics were used and models made using multiple logistic regression. Results: The prevalence of tobacco use (smoking and smokeless) and of tobacco and betel nut was 12.08% (CI 9.57 – 14.97) and 21.31% (CI 18.09 – 24.82), respectively. Risk taking attitude, prevalent in 16.11% (CI 13.25 – 19.31), was strongly linked with tobacco and betel nut use. Prevalence of correct knowledge about tobacco was only 37.75% (CI 33.84 – 41.78). Statistically significant associations were found between gender, type of school, risk taking attitude and use of tobacco (all forms) including betel nut chewing. Of the smokers, 41.6% started prior to the age of 12 years. Offer of cigarettes was made to 27.18% of children. Though 19.75% said they would smoke to gain acceptance, the number of undecided individuals was high (43.83%). Regression models showed that: students with less knowledge; higher risk taking attitude; and indulging in alcohol: used tobacco and betel nut more than others. Model also depicted that knowledge alone was not a good predictor of betel nut chewing. Conclusions: Statistically significant association of tobacco use in any form, with lack of knowledge, risk taking attitude and alcohol use, is consistent with predictors identified by other studies. A predictive model for children at risk for tobacco use has been proposed. Intensive efforts started early are needed for prevention of tobacco use in adolescents. No significant financial relationships to disclose.