Very few studies were reported on tobacco use in Indian school students in the past. Recently the global youth tobacco survey (GYTS) collaborative group(1) initiated a worldwide survey of students of the 13-15 years age in 150 countries including India. The objective of this letter is to highlight the lack of awareness of the harmful effects of tobacco use observed from first report(2) of GYTS in school children of Northeastern states of India. The State wise frequency of current tobacco use in any form and in cigarette form in some selected states of India reported by GYTS Collaborative Group(1) is shown in Fig. 1. It is evident from the figure that the frequency of tobacco use among school students is alarmingly high in Northeastern states of India and Bihar.

The current tobacco use (both smoke and smokeless) in any form in these Northeastern states(2) among boys was ranging from 50.4% to 74.4% while the use among girls ranged from 32.0% to 56.4%. The frequency of smoking among boys was from 28.6% to 40.8% and that of girls was from 8.9% and 28.2%. The use of cigarette among boys was from 13.1% to 32.8% and among the girls was from 2.5% to 13.4% in different states. The frequency of smokeless tobacco use among boys was from 35.0% to 52.5% and the girls 26.8% to 47.2%. These findings indicate high frequency of tobacco use even among girl students in the Northeast part of India. On the hand a Recent report of GYTS from Tamil Nadu(3) documented a low (7.1%) frequency of current tobacco use among school students.

Fig. 1. Percentage frequency of tobacco use among school students in some selected states of India.

It appears that the school students from North-eastern states(2) know very little about the ill effect of tobacco use and schools did not include much to its curriculum to educate the students on ill effects of tobacco use. Studies that determined the magnitude of tobacco use stressed the need for school health education programs to control this epidemic. To our knowledge, there is only one unique Indian study(4) of school-based intervention to reduce tobacco use among 12-year-old students. It was observed that intervention students were less likely to experiment or initiate, receive or intention to use tobacco than their non-intervention counter parts.

Thus, for preventing onset of tobacco use such intervention programs in the early adolescent period are essential on priority basis to bring behavioral change in school students especially in Northeastern states and Bihar.

Raj Narain,
L. Satyanarayana,
Division of Epidemiology & Biostatistics,
Institute of Cytology & Preventive Oncology (ICMR),
NOIDA-201 301, India.
E-mail: [email protected]

1. The Global Youth Tobacco Survey Collaborative Group. Tobacco use among youth: A cross-country comparison. Tobacco Control 2002; 11: 252-270.

2. Sinha DN, Gupta PC, Pednekar MS. Tobacco use among students in the eight North-Eastern States of India. Indian Journal Cancer 2003; 40: 43-59.

3. Gajalakshmi V, Asma S, Warren CW. Tobacco survey among youth in South India. Asian Pac J Cancer Prev. 2004; 5: 273-278.

4. Reddy KS, Arora M, Perry CL, Nair B, Kohli A, Lytle LA, et al. Tobacco and alcohol use outcomes of a school-based intervention in New Delhi. Am J Health Behav 2002; 26: 173-181.