Patterns of Tobacco Use and Psychosocial Risk Factors Among Students in 6th through 10th Grades in India: 2004-2006

Introduction: In 2004, baseline surveys of Project MYTRI, a randomized intervention trial in Chennai andDelhi, India, found that tobacco use among 6th graders was greater than that among 8th graders. These resultswere surprising - typically, tobacco use increases with grade level. The present study aimed to assess whetherthis unique differential was sustained over time, as students moved into higher grades.
Methods: Self-reporteddata from a sample of youth (n=3404) present at three annual surveys (2004, 2005, 2006) were analyzed. Mixedeffectsregression models were used to compare prevalence of lifetime tobacco use and nine psychosocial riskfactor scales between two student cohorts, 6th grade (or younger) cohort and 8th grade (or older) cohort. Stratifiedanalyses were also conducted by gender, age, city and school type.
Results: From 2004 to 2006, the 6th grade (oryounger) cohort of students reported higher rates of lifetime tobacco use, and these differences were maintainedover two years, even when the study sample was stratified by gender, age, city and school type. Similarly, studentsin the 6th grade (or younger) cohort scored greater risk for tobacco use on all psychosocial risk factors analyzedhere. Discussion: Tobacco use was found to be problematic among students in two Indian cities, particularly sofor those in younger grades. Projections of health impact due to tobacco may be larger than anticipated if theseadolescents continue to use tobacco as young adults. Further epidemiologic research and interventions to curbtobacco use among young(er) adolescents are warranted.