Adoption and Implementation of Tobacco Control Policies in Schools in India: Results of the Bihar School Teachers Study

Document Type : Systematic Review and Meta-analysis


1 Healis Sekhsaria Institute for Public Health, Navi Mumbai, India

2 Healis Sekhsaria Institute for Public Health, Navi Mumbai, Patna, India

3 Center for Community-Based Research, Dana Farber Cancer Institute; and Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, Massachusetts, USA

4 New England Research Institutes, Watertown, MA, USA

5 Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, USA

6 School of Preventive Oncology, Patna, India


Implementation of no tobacco policies in schools is associated with lower tobacco use among teachers and students. In this study we assessed the extent that a school-based intervention for teachers resulted in adoption and implementation of tobacco control policies. From a random sample of government schools (8th-10th), 72 were randomized into intervention and control conditions. Intervention included health education programs for teachers and support for tobacco control policy implementation. Adoption and implementation of policies were assessed at baseline and immediately after intervention. All 36 intervention and one control school adopted a tobacco-control policy. Higher enforcement of tobacco-control policy was at post intervention (OR=3.26; CI: 2.35, 4.54) compared to baseline in intervention schools. Some 64% of intervention and 28% control schools showed “improvement” in policy implementation. Adoption and implementation of no tobacco policies was positively impacted by intervention. This study provides support for scaling up of school-based tobacco control interventions to promote school tobacco control policies.