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Assessment of social determinants and prevalence of tobacco use among upper primary school students of Ahmedabad city, Gujarat, India

Darshana R Hirani, Yogitakumari M Patel, D V Bala.

Abstract
Background: Today’s adolescents are tomorrow’s citizens. Pandemic levels of tobacco use in children and adolescent have been reached. Violence within the family, stressful life events, negative peer influence, and so on are significantly associated with tobacco use and high-risk behavior.

Objective: (1) To study the sociodemographic profiles of the adolescent school students; (2) to study the social determinants responsible for tobacco addiction among adolescents; (3) to study the prevalence of tobacco consumption among them; and (4) to study the relationship between tobacco consumption and other associated variables.

Materials and Methods: By using multistage sampling method, a cross-sectional study was carried out among adolescent school students of Ahmedabad. According to the global study of Shah and Jathal (Global Youth Tobacco Survey, 2006), the prevalence of tobacco users was 14.6%; a sample size was calculated, and 2,842 adolescent school students studying in 18 municipal and grant-in-aid schools from all geographical zones of Ahmedabad were enrolled. Predesigned, structured questionnaires were given to students to be filled and collected back for data analysis. For raising awareness, health education session was organized by using audiovisual aids (PowerPoint presentation) regarding harmful effects of tobacco. Data were analyzed by using appropriate statistical software. The study was conducted during February 2013 to December 2014 after obtaining ethical consideration from the Education Officer of Ahmedabad city and principals of the respective schools by considering them as a legally acceptable guardian.

Result: Prevalence of tobacco use was 12.2%. The prevalence of tobacco use among boys was 16.2%; among girls, it was 6.5%. Use of both forms of tobacco and smoking was two- to threefold more in boys when compared with girls. Students initiated tobacco use as early as 8 years in either sex; 400 (14.1%) students motivated others to initiate chewing and 78 (2.7%) for smoking. About 19.8% students revealed their family members as tobacco consumers and 1,001 (35.2%) students have ever bought tobacco products either for themselves or for others. Among them, 124 (4.4%) were buying tobacco products daily, and 643 (65%) were asked to buy tobacco products by their family members. Half of the consumers confessed that they are unable to quit. All these factors influence the tobacco consumption among the young students.

Conclusion: This study found a significant association of tobacco use by the adolescents with family, which had one or more members who consume tobacco. Evident gender difference (male predominance) was also observed in tobacco use. Peer pressure and just for enjoyment were found the most common factors for tobacco consumption practices amongst school students.

Key words: Tobacco, family member, peer pressure, awareness, adolescents



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