title: Factors Associated with Tobacco Use in Students Attending Local Government Schools in Mumbai, India
abstract: Purpose: Factors associated with ever-use and differences between ever-users and non-users of tobacco among
  adolescent school students from low income families in Mumbai were assessed. Materials and Methods: A
  self-administered questionnaire, completed by 1918 students from grades 7, 8 and 9 in 12 schools managed by the city
  municipal corporation in July 2015, gathered data on socio-demographic characteristics, tobacco use and tobacco-related
  knowledge, attitudes and beliefs. Results: Although only 1% of respondents thought tobacco was cool, nearly 35%
  were unaware of associations between tobacco use and health problems. Male students were almost twice as likely
  (OR=2.5, P <= 0.05) to have ever used tobacco compared to females and Supari (areca nut) users were eight times
  more likely (OR=8.99, P < 0.001) than Supari non -users. Tobacco-users were more likely to agree with statements:
  ‘People who use tobacco have more friends’ (OR=2.8, P = 0.004), ‘Smoking relieves stress’ (OR=5.6, P = 0.002) and
  ‘It is possible to purchase any tobacco product within 100 yards of school’ (OR=10.8, P < 0.001). Conclusion: This
  study highlights the gains made by tobacco prevention campaigns in that almost all students did not consider tobacco
  as cool or a stress reliever. However, they still need education about health consequences of tobacco-use. In addition,
  Supari use has to be addressed in school-based tobacco prevention and cessation initiatives. Furthermore, programs
  must also address perceptions and norms related to peers and tobacco use and ensure active implementation of existing
  laws. Such integrated measures will help ensure tobacco-free spaces around schools.
authors.affiliation: Research Advisor, Salaam Bombay Foundation, Mumbai, India. Email: nileshchatterjee100@gmail.com
authors.forename: Nilesh
authors.initials: N
authors.lastname: Chatterjee
authors.forename: Priyamvada
authors.initials: P
authors.lastname: Todankar
authors.forename: Gauri
authors.initials: G
authors.lastname: Mandal
authors.forename: Himanshu
authors.initials: H
authors.lastname: Gupte
authors.forename: Vaibhav
authors.initials: V
authors.lastname: Thawal
authors.forename: Tshering
authors.initials: Ts
authors.lastname: Bhutia
authors.forename: Leni
authors.initials: L
authors.lastname: Choudhuri
keywords: Tobacco use; adolescents; Mumbai; India