Prevalence & correlates of tobacco use among adolescents in Kerala, India
Open accessAbstract
Background & objectives: Most tobacco users who initiate its use during adolescence are likely to continue the use into adulthood and contribute to the 90 per cent of premature deaths among tobacco users. In this context the prevalence, patterns and correlates of tobacco use were studied among adolescent school students in Kerala, India. Methods: Total 7560 students from classes 8, 10 and 12, within the age group of 12-19 yr, across 73 schools in Ernakulam district, Kerala, India, selected by cluster random sampling, completed a self-administered questionnaire incorporating standardized instruments. Results: Of the 7350 valid questionnaires, the overall lifetime prevalence of tobacco use was 6.9 per cent (12.5% males and 1.2% females). The prevalence of tobacco use increased from 3.1 per cent at 12-13 yr to 15.1 per cent at 18-19 yr. The mean age of onset of tobacco use was 14.0±2.2 yr. The prevalence was higher among students from urban backgrounds, lower socio-economic status and those with part-time jobs. Tobacco users had significantly higher rates of use of alcohol (67.8 vs. 11%) and illicit drugs (33 vs. 6.1%). They had poorer academic performance (24.7 vs. 9.1%), more severe psychological distress (10.8 vs. 4.5%), suicidal attempts (10.2 vs. 3.5%), higher scores of ratings of attention deficit hyperactivity disorder (8.3 vs. 2.5%) and history of sexual abuse (12.5 vs. 3.8%). Interpretation & conclusions: The prevalence of tobacco use in adolescents reported in this study was relatively lower than those reported from other Indian States. However, it correlates with multiple negative outcomes suggesting a need to promote specific interventions to prevent adolescent tobacco use.
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Psychiatric issues, illicit substance use, and general psychological distress of young people often go unnoticed and are underdiagnosed and undertreated.
“Psychiatric issues, illicit substance use, and general psychological distress of young people often go unnoticed and are underdiagnosed and undertreated, as mental health issues add to their distress, while stigma and other environmental factors prevent them from seeking help.9–11”
From Mental Health, Suicidality, Health, and Social Indicators Among College Students Across Nine States in India (2025) · cites this paper as [9]
The Discussion (page unavailable) reports an association between tobacco use and psychological distress among adolescents, but does not say these problems often go unnoticed, undiagnosed, or untreated. Searches for underdiagnosis, treatment, stigma, and help-seeking found no passage addressing those claims. (LLM, conf=0.76)
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- Authors
- Jaisoorya, T. S., Beena, K. V., Beena, M., Jose, D. C., Ellangovan, K., Thennarasu, K., & Benegal, V.
- Affiliations
- National Institute of Mental Health and Neurosciences (IN)
- Corresponding author
- Jaisoorya, T. S.
- Venue
- Indian Journal of Medical Research
- Publisher
- Scientific Scholar
- Published
- 2016-11
- Volume
- 144
- Issue
- 5
- Pages
- 704-711
- ISSN
- 0971-5916 (ISSN-L)
- PMC
- PMC5393081
- OpenAlex
- W2599402779
- Cited by
- 47
- References
- 23
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 8 · 2023: 7 · 2022: 5 · 2021: 9 · 2020: 4 · 2019: 2 · 2018: 2
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Indian Journal of Medical Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-sa)
- PubMed Central (publishedVersion, cc-by-nc-sa)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Health Professions › Speech and Hearing › School Health and Nursing Education
- Keywords
- adolescent tobacco use, smoking prevalence, age of onset, alcohol consumption, illicit drug use, academic performance, psychological distress, suicide attempts, attention deficit hyperactivity disorder, sexual abuse history, socioeconomic status, urban-rural differences, Kerala, Ernakulam district
- MeSH terms
- Adolescent, Adolescent Behavior, Child, Female, Humans, India, Male, Surveys and Questionnaires, Smoking, Social Class, Tobacco Use Disorder, Young Adult
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