title: Social contextual factors and tobacco use among Indian teachers: insights from the Bihar School Teachers' Study.
abstract: OBJECTIVE
  Tobacco use within India has significant effects on the global burden of tobacco-related disease. As role models and opinion leaders, teachers are at the forefront of tobacco control efforts, yet little is known about their own tobacco use. This study examines the association between factors in the social environment and tobacco use among teachers in Bihar, India.
  
  
  METHODS
  The study was based on the Bihar School Teachers' Study baseline survey. Seventy-two Bihar government schools (grades 8-10) were randomly selected for the study and all school personnel were invited to complete the survey in June/July in 2009 and 2010. We assessed the relation between social contextual factors and current smoking/smokeless tobacco use by fitting a series of logistic regression models.
  
  
  RESULTS
  After controlling for clustering of teachers in schools and other covariates, our results showed teachers with one or more coworkers who used tobacco were twice as likely to be smokeless tobacco users as teachers with no co-workers who used tobacco. Teachers who reported rules prohibiting smoking at home were significantly less likely to smoke than teachers without such rules. Older male teachers also had significantly greater odds of smoking/using smokeless tobacco.
  
  
  CONCLUSIONS
  These findings provide direction for future interventions targeting the social context.
authors: Dana-Farber Cancer Institute, Center for Community Based Research, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue-7th Floor, Boston, MA 02115, USA. Electronic address: eve_nagler@dfci.harvard.edu.
authors: Eve M
authors: EM
authors: Nagler
authors: WHO Regional Office for South-East Asia, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi 110002, India.
authors: Dhirendra N
authors: DN
authors: Sinha
authors: Healis Sekhsaria Institute For Public Health, 501, Technocity, Plot-X-4/5, TTC Industrial Area, Mahape, Navi Mumbai, Pin code-400701, Maharashtra, India.
authors: Mangesh S
authors: MS
authors: Pednekar
authors: New England Research Institutes, 480 Pleasant Street, Watertown, MA 02472, USA.
authors: Anne M
authors: AM
authors: Stoddard
authors: Healis Sekhsaria Institute For Public Health, 501, Technocity, Plot-X-4/5, TTC Industrial Area, Mahape, Navi Mumbai, Pin code-400701, Maharashtra, India.
authors: Prakash C
authors: PC
authors: Gupta
authors: Healis Sekhsaria Institute For Public Health, 501, Technocity, Plot-X-4/5, TTC Industrial Area, Mahape, Navi Mumbai, Pin code-400701, Maharashtra, India.
authors: Neha
authors: N
authors: Mathur
authors: University of Minnesota School of Public Health, Division of Epidemiology & Community Health, 1300S. 2nd Street, Suite 300, Minneapolis, MN 55454, USA.
authors: Harry
authors: H
authors: Lando
authors: Freelance Behavioral Scientist, New Delhi 110016, India.
authors: Mira
authors: M
authors: Aghi
authors: Dana-Farber Cancer Institute, Center for Community Based Research, 450 Brookline Ave, Boston, MA 02215, USA.
authors: Laura Shulman
authors: LS
authors: Cordeira
authors: Dana-Farber Cancer Institute, Center for Community Based Research, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue-7th Floor, Boston, MA 02115, USA.
authors: K
authors: K
authors: Viswanath
authors: Dana-Farber Cancer Institute, Center for Community Based Research, 450 Brookline Ave, Boston, MA 02215, USA; Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue-7th Floor, Boston, MA 02115, USA.
authors: Glorian
authors: G
authors: Sorensen
mesh_terms: D000328:Adult; D005178:Faculty / Q000706:statistics & numerical data*; D005195:Family Relations; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*; D012931:Social Environment; D066262:Social Norms; D066252:Sociological Factors; D011795:Surveys and Questionnaires; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data*
keywords: Co-workers; Family influence; India; Schools; Social context; Teachers; Tobacco use
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