title: Substance use among adolescent high school students in India: A survey of knowledge, attitude, and opinion.
abstract: BACKGROUND
  Is knowledge regarding the consequences of substance use among adolescents enough to prevent them from initiating and continuing its use, is a question that needs to be clarified further?
  
  
  OBJECTIVE
  To assess the knowledge regarding harm of use and to obtain information about attitudes among high school students. Also, to discover the opinion of substance use held by users.
  
  
  METHODS
  This was a population based cross-sectional study conducted in two high schools of West Bengal, India, among 416 students, in classes VIII, IX, and X, with no interventions. Primary outcome measurements were substance use: knowledge regarding harm, attitude, and opinion. Following this proportions and the chi-square test were used for statistical analysis.
  
  
  RESULTS
  Out of 416 students, 52 (12.5%) used or abused any one of the substances irrespective of time and frequency in lifetime; 26 (15.1 %) were among the urban students and 26 (10.7 %) were among their rural counterparts. More than two-thirds (73.07%) of the respondents expressed a desire to quit substance use and 57.69% had tried to stop. 'Easy availability' and 'relief from tension' were the most frequent reasons for continuation of substance use. Level of knowledge on harmfulness of substance use among students was very high (urban - -84.6% and rural - 61.5%) and they stated media as the most frequent source of information. Users were successful in influencing their peers into taking up this habit (urban - 15.4% and rural - 26.9%).
  
  
  CONCLUSIONS
  Inspite of being aware of the harmful effects of substance use, adolescents take up this habit. This requires comprehensive prevention and control programs in schools and the community, targeted toward adolescents and their parents and other family members. Effective measures are required to encourage shaping the attitude of school children toward self-confidence and adequacy, as also to prevent risk behavior among adolescents.
authors.affiliation: Department of Community Medicine, Sikkim Manipal Institute of Medical Sciences (SMIMS) and Central Referral Hospital (CRH), 5th Mile, Tadong, Gangtok, Sikkim-737102, India.
authors.forename: Dechenla
authors.initials: D
authors.lastname: Tsering
authors.forename: Ranabir
authors.initials: R
authors.lastname: Pal
authors.forename: Aparajita
authors.initials: A
authors.lastname: Dasgupta