Awareness about effects of tobacco and areca-nut use in school children of Ahmedabad, India: A cross-sectional questionnaire-based survey
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LJ Institute of Physiotherapy, Ahmedabad, India
SBB College of Physiotherapy, Ahmedabad, India
Mission Health Physiotherapy Clinic, Ahmedabad, India
Priya Singh Rangey   

LJ Institute of Physiotherapy, E-502, Devnandan Platina, Opposite Shayona Tilak, Near Vande Mataram City, Gota, 382481 Ahmedabad, India
Publication date: 2018-10-24
Submission date: 2017-09-18
Final revision date: 2018-10-13
Acceptance date: 2018-10-15
Tob. Prev. Cessation 2018;4(October):34
Tobacco use usually starts in the adolescent age group and continues in adulthood. This study’s aim was to identify knowledge regarding the adverse effects of tobacco and areca-nut use among high school children of Ahmedabad, India.

An anonymous self-administered close-ended questionnaire was designed for the study. Principals of 9 schools, 3 municipal and 6 government-aided, were approached and written informed consent was obtained. A total of 3055 students studying in grades 7–12 were included. Data were analyzed using Microsoft Excel and SPSS 16.0. Chi-squared test was applied to investigate any differences between the responses of consumers and non-consumers, while Cramer’s V was applied to analyze the strength of association between the awareness of ill-effects and tobacco product consumption.

Of the 3055 children, 3% felt that tobacco use was definitely not harmful to health while 84% felt that it was. In all, 65% of respondents were aware that tobacco use caused cancer, 7% answered that it caused breathing problems, 5% said it caused heart problems, 0.3% answered that it caused paralysis, 4.3% felt it caused no health problems, whereas 18% thought that it caused multiple issues. With regards to the role of media, 78% had seen many anti-smoking warnings in the media, 15% had seen a few, 5% had seen none. There was a statistically significant difference between the tobacco users and and non-users with regards to exposure to media (p<0.001), discussions in class (p<0.001) and general awareness (p<0.001), but a weak association between awareness and tobacco consumption was identified (p<0.05).

Awareness about the harmful effects of tobacco is high among school children of Ahmedabad, though use may still be prevalent.

Narain R, Sardana S, Gupta S, et al. Age at initiation & prevalence of tobacco use among school children in Noida, India: A cross-sectional questionnaire based survey. Indian J Med Res. 2011;133(3):300-7.
Sinha DN, Reddy KS, Rahman K, Warren CW, Jones NR, Asma S. Linking Global Youth Tobacco Survey (GYTS) data to the WHO framework convention on tobacco control: the case for India. Indian J Public Health. 2006;Apr-Jun 50(2):76-89.
Gupta Bhawan. Burden of Smoked and Smokeless Tobacco Consumption in India - Results from the Global adult Tobacco Survey India (GATS-India)- 2009-2010. Asian Pacific Journal of Cancer Prevention. 2013;14(5):3323-9.
Trivedy CR, Craig G, Warnakulasuriya S. The oral health consequences of chewing areca nut. Addiction Biology. 2002;7(1):115-25. doi:10.1080/13556210120091482
Auluck A, Hislop G, Poh C, Zhang L, Rosin MP. Areca nut and betel quid chewing among South Asian immigrants to Western countries and its implications for oral cancer screening. Rural Remote Health. 2009;9:1118.
Chadda RK, Sengupta SN. Tobacco use by Indian adolescents. Tob Induc Dis. 2003;1(1):8. doi:10.1186/1617-9625-1-8
DiFranza JR, Rigotti NA, McNeill AD, et al. Initial Symptoms of Nicotine Dependence in Adolescents. Tob Control. 2000;9(3):313-9. doi:10.1136/tc.9.3.313
Kaur J, Jain DC. Tobacco Control Policies in India: Implementation and Challenges. Indian J Public Health. 2011;55(3):220-7. doi:10.4103/0019-557x.89941
Taran SJ, Taran R, Saroshe S, Bhandari V. A cross sectional study to assess the prevalence and awareness of tobacco consumption among school students in a cosmopolitan city of India. Int J Contemp Pediatr. 2016 Feb;3(1):86-90. doi:10.18203/2349-3291.ijcp20160076
Tiwari RV, Megalamanegowdru J, Gupta A,et al. Knowledge, Attitude and Practice of Tobacco Use and Oral Health of Children in Chhattisgarh, India. Asian Pacific Journal of Cancer Prevention. 2014 Jan;15(23):10129-35. doi:10.7314/apjcp.2014.15.23.10129
Swadi H, Zeitlin H: Drug education to school children: does it really work? British Journal of Addiction. 1987,82(7):741-746. doi:10.1111/j.1360-0443.1987.tb01540.x
Khandelwal A, Khandelwal V, Saha MK, Khandelwal S, Prasad S, Saha SG. Prevalence of areca nut chewing in the middle school going children of Indore, India. Contemporary Clinical Dentistry. Apr-Jun 2012;3(2):155-157. doi:10.4103/0976-237x.96817