Tobacco use related attitudes and behaviors in Indian Adolescents: association with school-based prevention education

Background: Adolescent tobacco use in India has increased substantially within the past few decades. Schools can serve as an important avenue for prevention education, but little is known about the current practices of Indian schools in relation to tobacco use prevention education. Methods: To assess the extent and influence tobacco use prevention education in Indian schools,we analyzed the Global Youth Tobacco Survey data for India, which was a population-based study of a national random sample of 10112 students from 180 private and public schools.Variables such as student demographic profile, tobacco use behavior, perceptions about tobacco use, and exposure to school-based tobacco use prevention education were considered for analyses. Results: Prevalence of any form of tobacco use (14%) and current smoking (8%) was found to differ by gender. A quarter of the students believed that boys who smoke are more attractive or have more friends compared to non-smokers, and almost half of the students reported that smoking and health were never discussed as a part of a lesson in school. The association between school-based prevention education and tobacco use behavior was assessed (after adjustment forage, gender, and parental smoking). Students who were educated in school about tobacco use and its effects were significantly more likely to have negative attitude toward tobacco use and less likely to report use of tobacco. Conclusion: School-based tobacco use prevention education has beneficial influence on adolescents in India. Given the early age of initiation of tobacco use, school curricula in India should emphasize on tobacco use prevention education.