title: Self-reported tobacco use, knowledge on tobacco legislation and tobacco hazards among adolescents in rural Kerala State.
abstract: BACKGROUND
  Tobacco consumption initiated during the adolescent period is a major contributor to the pathogenesis of fatal diseases in adulthood. Information on tobacco use and awareness regarding tobacco legislation and hazards among adolescents in rural Kerala is limited.
  
  
  OBJECTIVE
  To assess the prevalence of tobacco use among adolescent students in a rural district in Kerala state and to understand the extent of awareness about the prominent legislative measures against tobacco and tobacco hazards.
  
  
  METHODS
  Data on awareness regarding health hazards due to tobacco use and legislation against tobacco consumption were collected from students of 15 randomly selected high schools in an educational sub-district in Kerala, using a cross-sectional study design. Chi-square and Fisher's exact test statistics were used for statistical analysis.
  
  
  RESULTS
  A total of 1473 students participated in the study, of which 79% were males (mean age 15.4 years, SD 1.5). The overall prevalence of 'current tobacco users' was 8%. A significant association between age and tobacco use was noted among tobacco habitués (P<0.05). Awareness regarding legislation against smoking in public places was more in the higher age-groups (P<0.05). Females were more aware of the 'smoking ban' than males (P<0.05). Our survey of the awareness regarding the hazards associated with tobacco use revealed that 41.5% of the students knew about the link between oral cancer and tobacco, with the awareness being greater among females than among males (64.3% vs 35.4%).
  
  
  CONCLUSIONS
  The finding that tobacco consumption increases with age is a matter of concern. In addition to their clinical work, dental professionals should also educate the public on the hazards of tobacco and conduct tobacco cessation programmes for adolescent groups to control the tobacco epidemic.
authors: Department of Community Oncology, Tobacco Cessation Centre, Regional Cancer Centre, Thiruvananthapuram, India. jaykrishnan999@gmail.com
authors: Radhakrishnan
authors: R
authors: Jayakrishnan
authors: Seema
authors: S
authors: Geetha
authors: Bhaskarapillai
authors: B
authors: Binukumar
authors: Kamala
authors: K
authors: Lekshmi
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009062:Mouth Neoplasms / Q000209:etiology; D015995:Prevalence; D012140:Respiratory Tract Diseases / Q000209:etiology; D012423:Rural Health / Q000706:statistics & numerical data*; D057566:Self Report; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology* / Q000331:legislation & jurisprudence; D000074606:Smoking Prevention; D055815:Young Adult; D014026:Nicotiana