Tobacco Consumption, Early Initiation, and Determinants Among School-Going Adolescents in Ranchi, Jharkhand: A Cross-Sectional Study.

Objective

India faces a rapidly increasing burden of oral cancer. Adolescence is a critical period for risk-taking behaviours, yet state-level, school-based data from high-burden regions such as Jharkhand are limited. To estimate the prevalence and patterns of tobacco use and identify socio-demographic, familial, and awareness-related predictors of ever tobacco use among school-going children in Ranchi, Jharkhand.

Methods

A cross-sectional survey was conducted among 898 students from government and government-aided schools in Ranchi using a pre-tested, structured, self-administered questionnaire. Data included demographics, awareness, tobacco use, social influences, and attitudes toward tobacco control. Ever tobacco use was defined as lifetime use of smoked or smokeless tobacco; current use was defined as use within the past 30 days among ever users. Prevalence was estimated with 95% confidence intervals (CIs). Chi-square tests assessed associations, and logistic regression identified independent predictors.

Results

Of 898 students (52.1% girls; mean age 15.6 years), 7.9% (95% CI 6.1-9.7) had ever used tobacco. Among ever users, 22.5% were current users and 50.7% had discontinued. Ever use was higher among boys than girls (12.4% vs 4.1%; OR 3.36, 95% CI 1.95-5.78). However, among ever users, girls were more likely to be current users (OR 5.79, 95% CI 1.74-19.25). Initiation clustered between 10-15 years. In multivariable analysis, male gender (adjusted OR 2.76, 95% CI 1.55-4.93) and family tobacco use (adjusted OR 1.77, 95% CI 1.06-2.95) were independent predictors.

Conclusion

Tobacco experimentation begins by mid-adolescence in Ranchi. Prevention should start before age 10, emphasize family-centred strategies, and address social modelling beyond awareness programmes.