Sarita Sardana and Raj Narain

Addiction to tobacco and harmful non-tobacco products by youth is assuming alarming proportion in our country [1-3]. A cross-sectional study was undertaken to determine the prevalence and age at initiation of tobacco and non-tobacco use among school children. Data were collected from students of class 7 to 12 (ages: 11-18 years) in the year 2005, through cluster and random sampling using a self- administered anonymous pretested questionnaire. The study was approved by institutional ethical and review committee. An informed consent from the students as well as student’s parents and school authorities was obtained. The sample size calculated was 5600, assuming the prevalence of tobacco use as 6.0%, a relative precision of 10% and confidence interval of 95%. The habits were classified as ‘Exclusive use of tobacco’, ‘Exclusive use of non-tobacco’ (the use of only tobacco or only non-tobacco, even once, in any form during life time, including current use) or ‘Both habits’ (the use of tobacco and non-tobacco even once in any form). Tobacco use included smoking of cigarettes, Beedis, Hookah, Chillum, Ganja etc. and chewing of Gutka, Khaini and Zarda. Non-tobacco comprised of betel quid and pan masala. Differences in proportions and mean age of initiation were tested using Pearson’s Chi-Square test and Students t-test respectively.

A total of 4786/5600 (85.0%) students responded. ‘Exclusive tobacco use’ ‘Exclusive non-tobacco chewing’ and ‘Both habits’ were found in 7.4%, 8.9% and 4.4% students. There was no significant gender difference in the prevalence of ‘exclusive tobacco use’ and ‘exclusive non-tobacco use’. Interestingly, girls were found to initiate both the habits significantly earlier than boys. (tobacco: girls 12.1 years vs. boys 12.6 years; non-tobacco: girls 11.4 years vs. boys 12.0 years (Table-I). The mean age of initiating the non-tobacco habit (11.7 years) was significantly lower than the mean age of initiating tobacco habit (12.3 years) irrespective of the gender. While boys adopted these habits usually to refresh themselves or to look smart, girls more often took to these habits to make friends. More than 70% of tobacco users who visited the street vendor were not refused tobacco products despite the ban by the Government.

Table I 



Prevalence and Mean Age of Initiation of Tobacco and Non-tobacco Habits Among Boys and Girls

The study highlights rising prevalence of non-tobacco habit in addition to tobacco addiction among girl students and early uptake of these habits. Health awareness, psycho-behavioral change and education programs, strict enforcement of laws to ban sale of these products to the under-aged are urgently needed to curb these habits before they assume epidemic proportions [4,5].

Acknowledgment: Dr Sanjay Gupta and Dr Ashok Sehgal for their valuable support in preparation of the manuscript.