Special Report - Tobacco use among Students in the Eight North-Eastern States of India

OBJECTIVES: To obtain baseline information about prevalence of tobacco use among school children in eight states in the North-eastern part of India. MATERIAL AND METHODS: A two-stage probability sample of students in grades 8_10 corresponding to 13 to 15 years of age was selected in each state and surveyed through an anonymous, self-administered questionnaire. RESULTS: Among the sampled schools, the school response rate was 100% in all states except Tripura (92%) and Meghalaya (96%). Among the eligible students, over 80% participated in the survey. Among the respondents, the proportion of boys ranged between 50% to 55%. Ever tobacco users ranged from 75.3% (Mizoram) to 40.1% (Assam). Over 65% of users reported initiation at 10 years of age or earlier in all states except Mizoram (23.1%). The range of current tobacco use (any product) was 63% (Nagaland) to 36.1% (Assam). Current smokeless tobacco use ranged from 49.9% (Nagaland) to 25.3% (Assam). Mizoram reported the highest current smoking (34.5%, mainly cigarette) and Assam reported the lowest (19.7%, again mainly cigarette). Current smoking among girls (8.3% to 28.2%) was also quite high. Over half of current cigarette smokers (53.2% to 96.3%) and a high proportion of current smokeless tobacco users (38.5% to 80.8%) reported feeling like having tobacco first thing in the morning. Only about 20% of students reported having been taught in school about the dangers of tobacco use, except in Mizoram (around 50%). Tobacco use by parents and close friends was positively associated with students' current tobacco use. CONCLUSIONS: Tobacco use including smoking was very high, even among girls, in all eight states in the North-eastern part of India. Signs of tobacco dependency were already visible in these students, more among those who smoked. In general schools did not educate students about the hazards of tobacco use.