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

  • Mathur, N (Healis Sekhsaria Institute for Public Health, Navi Mumbai) ;
  • Pednekar, MS (Healis Sekhsaria Institute for Public Health, Navi Mumbai) ;
  • Sorensen, GS (Center for Community-Based Research, Dana Farber Cancer Institute, Department of Social and Behavioral Sciences, Harvard School of Public Health) ;
  • Nagler, EM (Center for Community-Based Research, Dana Farber Cancer Institute, Department of Social and Behavioral Sciences, Harvard School of Public Health) ;
  • Stoddard, AM (New England Research Institutes) ;
  • Lando, HA (Division of Epidemiology and Community Health, University of Minnesota) ;
  • Aghi, MB (Healis Sekhsaria Institute for Public Health, Navi Mumbai) ;
  • Sinha, DN (School of Preventive Oncology) ;
  • Gupta, PC (Healis Sekhsaria Institute for Public Health, Navi Mumbai)
  • Published : 2016.06.01

Abstract

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 ($8^{th}-10^{th}$), 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.

Keywords

Tobacco policy;schools;adoption;implementation;intervention;India

References

  1. ACharlton A, While D (1994). Smoking prevalence among 1619 year olds related to staff and student smoking policies in sixth forms and further education. Health Educ J, 53, 191-215.
  2. Goldstein AO, Peterson AB, Ribisl KM, et al (2003). Passage of 100% tobacco-free school policies in 14 north carolina school districts. J School Health, 73, 293-29. https://doi.org/10.1111/j.1746-1561.2003.tb06585.x
  3. Kaur J, Jain DC (2011). Tobacco control policies in india: implementation and challenges. Indian J Public Health, 55, 220-7. https://doi.org/10.4103/0019-557X.89941
  4. Ministry of Health and Family Welfare, Government of India (2003). Cigarettes and other tobacco products (prohibition of advertisement and regulation of trade and commerce, production, supply and distribution) Act, 2003, New Delhi: India.
  5. Ministry of Health and Family Welfare, Government of India (2009). Guidelines for tobacco- free schools / educational institutions.
  6. Nagler EM, Pednekar MS, Viswanath K, et al (2013). Designing in the social context: using the social contextual model of health behavior change to develop a tobacco control intervention for teachers in India. Health Educ Res, 28, 113-29 https://doi.org/10.1093/her/cys060
  7. Pawar PS, Nagler EM, Gupta PC, et al (2015). Tracking intervention delivery in 'tobacco-free teachers/tobacco-free society' program, Bihar, India. Health Educ Res, 30, 731-41. https://doi.org/10.1093/her/cyv039
  8. Pentz MA, Dwyer JH, MacKinnon DP, et al (1989). A multicommunity trial for primary prevention of adolescent drug abuse: Effects on drug use prevalence. J Am Med Associat, 261, 3259-66. https://doi.org/10.1001/jama.1989.03420220073030
  9. Pentz MA, Sussman S, Newman T (1997). The conflict between least harm and no use tobacco policy for youth: ethical and policy implications. Addict, 92, 1165-73. https://doi.org/10.1111/j.1360-0443.1997.tb03676.x
  10. Sinha DN, Gupta PC, Warren CW, et al (2004). School policy and tobacco use by students in Bihar, India. Indian J Public Health, 48, 118-22.
  11. Sinha DN, Gupta PC, Warren CW, et al (2004). Effect of school policy on tobacco use by school personnel in Bihar, India J Sch Health, 74, 3-5. https://doi.org/10.1111/j.1746-1561.2004.tb06592.x
  12. Sinha DN, Gupta PC, Pednekar MS (2004). Tobacco use among students in Bihar (India). Indian J Public Health, 48, 111-7.
  13. Sorensen G, Gupta PC, Sinha DN, et al (2005). Teacher tobacco use and tobacco use prevention in two regions in India: results of the global school personnel Survey. Prev Med, 41, 417-23. https://doi.org/10.1016/j.ypmed.2004.09.048
  14. Sorensen GS, Pednekar MS, Sinha DN, et al (2013). Effects of a tobacco control intervention for teachers in India: results of the Bihar school teachers study. Am J Public Health , 103, 2035-40. https://doi.org/10.2105/AJPH.2013.301303
  15. Stephens Y, English G (2002). A statewide school tobacco policy review: Process, results, and implications. J School Health, 72, 334-338. https://doi.org/10.1111/j.1746-1561.2002.tb07920.x
  16. World Health Organization (2011). WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco. Geneva.
  17. World Health Organization (2013). WHO report on the global tobacco epidemic, 2013: Enforcing bans on tobacco advertising, promotion and sponsorship. Geneva.