Tobacco Use and Its Correlates among 13-15-Year-Old School Children in Barpeta District, Assam

Abstract

Background: Tobacco use during adolescence is a major public health concern. Early initiation increases the risk of long-term dependence and disease. Smokeless tobacco use is deeply embedded in the sociocultural practices particularly in Northeast India. However, data on adolescent tobacco use in Assam remain limited. This study assessed tobacco use and its correlates among 13-15-year-old school children in Barpeta District, Lower Assam, using a Global Youth Tobacco Survey (GYTS)-based questionnaire. Material and Methods: A descriptive cross-sectional study was conducted among 269 school-going adolescents aged 13–15 years in a single school in Barpeta District over one month (November–December 2025). Data on sociodemographic profile, parental tobacco exposure, tobacco use behaviour, dependence indicators, and secondhand-smoke exposure were collected using a structured, self-administered questionnaire. Chisquare/Fisher's exact tests and binary logistic regression were used for analysis, with crude and adjusted odds ratios (COR, AOR) reported at 95% confidence intervals. Results: The overall prevalence of tobacco use was 25.65%, with smokeless tobacco predominant (67.21%) and betel nut alone the most commonly used product (60.65%). Parental tobacco use was the strongest independent predictor of adolescent use (AOR 8.09, 95% CI 4.08–16.02, p<0.001); paternal high-school education was also significantly associated (AOR 4.21, p=0.027). Only 43.5% of participants were aware that passive smoking is harmful, and 78.26% accessed tobacco through friends or family. Conclusion: Tobacco use among adolescents in Barpeta District is substantially high and closely linked to parental tobacco use and low secondhand-smoke awareness, highlighting the need for family-oriented, culturally tailored school-based interventions.