183929 Differences in tobacco use and related psychosocial risk factors among youth in urban India by grade level, socioeconomic status, gender, and city: Assessment of Project MYTRI follow-up surveys (2005 and 2006)

Monday, October 27, 2008

Poonam Dhavan, MBBS, DHA, MPH , School of Public Health, University of Texas, Houston, TX
Melissa H. Stigler, PhD , School of Public Health, Austin Regional Campus, University of Texas, Austin, TX
Cheryl Perry, PhD , School of Public Health, Austin Regional Campus, University of Texas, Austin, TX
Monika Arora, MS , Health Related Information Dissemination Amongst Youth (HRIDAY), New Delhi, India
K. Srinath Reddy, MD , Public Health Foundation of India, New Delhi, India
Project MYTRI (Mobilising Youth for Tobacco-Related Initiatives in India) was a large 2-year randomized community trial whose goal was to prevent and reduce tobacco use among youth in the 6th and 8th grades in Delhi and Chennai, India (n=32 schools)(1). Analysis of baseline data in 2004 showed that students in the 6th grade reported more tobacco use than students in the 8th grade opposite of what is typically observed in the West(2,3,4).

The present study aims to assess whether these unusual differences in tobacco use persisted into subsequent years. Repeated cross-sectional surveys were conducted in 2005 and 2006, when students were in the 7th/9th (n=~5898) and 8th/10th grades (n=~5495), respectively. Mixed-effects regression models adjusted for age and stratified by city, gender, and SES were used to test for differences by grade. Initial analyses suggest that lower grades continued to report more tobacco use compared to higher grades in 2005 [p<0.001] and 2006 [p<0.05]. In 2005, differences were maintained by gender (boys [p<0.001], girls [p<0.05]) and SES (Private schools [p<0.05], Government schools [p<0.001]); in 2006, they were maintained only in Government schools [p<0.05]. Differences in psychosocial risk factors for tobacco use also seem to have persisted, with intentions to chew and smoke tobacco greater among 7th (vs. 9th) graders in 2005 [p<0.001] and greater in 8th (vs. 10th) graders in 2006 [p<0.05].

These findings suggest that younger cohorts of youth might be at greater risk for tobacco use, which has important policy implications for tobacco control in India and similar settings.

Learning Objectives:
1.Describe the distribution of tobacco use (i.e., cigarette smoking, bidi smoking, and chewing tobacco) among urban youth in India by school grade (6th-8th grades vs. 8th-10th grades), age, gender(girls vs. boys), socioeconomic status (lower SES vs. higher SES), and city (Delhi vs. Chennai). 2.Describe the distribution of psychosocial risk factors for tobacco use (e.g., intentions to use tobacco, susceptibility to tobacco use, reasons to use tobacco, social norms about tobacco use) among urban youth in India by the same socio-demographic factors as above. 3.Identify appropriate tobacco interventions for youth in this setting, with particular attention to which age-groups to target for behavioral interventions.

Keywords: Tobacco, Youth

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I started my career in global tobacco control as a technical officer for the World Health Organization (WHO) Tobacco Free Initiative in Geneva (2002 to 2006). I have also worked at national level with the Public Health Foundation of India (2007). I have provided technical writing consultancy to the WHO Southeast Asia Regional Office for developing proposals to the Bloomberg global tobacco grants program. Since Fall 2007, as an MPH epidemiology student, I am working as a research assistant at the UT Dell Center for Advancement of Healthy Living, on tobacco control and obesity-related projects. My work experience, training in epidemiology and ongoing research enable me to conduct the present study and understand its policy and program implications. I have previously made presentations during international capacity building workshops organized by WHO. I hope to add value to the APHA sessions on tobacco control by sharing and discussing results of this interesting study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.