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)

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.