Why Do the Youths in Northeast India Use Tobacco?

Hindawi Journal of Environmental and Public Health Volume 2017, Article ID 1391253, 6 pages https://doi.org/10.1155/2017/1391253 Research Article Why Do the Youths in Northeast India Use Tobacco? Laishram Ladusingh,1 Preeti Dhillon,1 and Pralip Kumar Narzary2 1 Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, India Department of Development Studies, International Institute for Population Sciences, Mumbai, India 2 Correspondence should be addressed to Pralip Kumar Narzary; Received 14 December 2016; Accepted 11 May 2017; Published 31 May 2017 Academic Editor: Suminori Akiba Copyright © 2017 Laishram Ladusingh et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This study is an assessment of the influence of parent’s tobacco use on prospective tobacco use trajectories among young offspring. The study is based on unit level data from District Level Household and Facility Survey-4 (2012-2013) comprising 27,706 youths in 15–24 years’ age group from northeastern states of India and used multilevel regression to identify the potential risk factors of tobacco consumption. The likelihood of using tobacco was found to be 3.4 and 1.14 times more, respectively, for the youths coresiding with mothers who use tobacco and fathers who use tobacco, in comparison to youths staying with parents not taking tobacco. The significant effect of peers on tobacco consumption among youths was also observed. School-going youths had significantly lower risk of tobacco use. The estimated likelihood of a young person from a household to use any tobacco, use smokeless tobacco, and smoke was found to be 28, 12, and 17 percent, respectively. There is an urgent need to extend National Tobacco Control Programme (NTCP) to the community level involving civil societies and young and adult generations for spreading awareness about the health hazards of tobacco use, providing support and facilitating quitting tobacco use. 1. Introduction Most tobacco users started consumption of tobacco in their childhood and teens initially to show that they are mature and grown-up or accompany friends or experience the thrill of experimenting something forbidden or imitate their movie heroes and then they slowly get addicted to nicotine making it hard to quit afterwards despite repeated attempts. Nipping the problem in the bud, preventing youths from using tobacco products can effectively curtail tobacco use. Assessment of hurdles and searching for evidence-based policy inputs for amendment and strengthening of current policies to prevent tobacco use at young age are important from public health perspectives as smoking in young age is associated with incidence of asthma and chronic cough [1], cardiovascular disease, and cancer [2]. The Cigarettes and Other Tobacco Products Act (COTPA) of 2003 prohibits smoking in public places, prohibits sale of tobacco products to and by minors under 18 years, bans sale of tobacco products within 100 yards of all educational institutions, and made it mandatory to display pictorial fatal health warnings on tobacco products packages [3]. To strengthen implementation of COTPA, the Government of India enacted pilot-based National Tobacco Control Programme (NTCP) by setting up tobacco control cells at state levels for effective implementation and monitoring of antitobacco laws and initiatives [4]. The question is as follows: is COTPA effective in controlling tobacco use among teens and youths particularly in northeast India? The answer is a clear no, as evident from a study [5] that prevalence of smoking among students ranges from 34.5 percent in Mizoram to 19.7 percent in Assam and age at initiation of smoking is as low as 10 years, and prevalence of smoking among adults 15 years and older as in 2009-2010 was 35.4 percent and 10.7 percent in the aforesaid two states in the same order [6]. Based on a study of school-going children aged 11–19 years in Noida, Narain et al. (2013) [7] have found 4.1 percent of them to be currently using tobacco. Bagchi et al. (2014) [8] reported the high prevalence rate of 29.6 percent among adolescent students in Kolkata and age at initiation of smoking as 13.6 years. In the National Capital Territory (NCT), 5.4 percent of school children aged 13–18 years were found to be current tobacco users [9]. From an 2 Journal of Environmental and Public Health assessment of prevalence and correlates of tobacco use among 10–12-year-old students in Patna, Singh et al. (2005) [10] have found that 6 percent of the boys and 3.2 percent of girls were current tobacco users. Among school children in Jaipur, 2.1 percent of boys and 1.5 percent of the girls were reported as current tobacco users from a study of 10 randomly selected schools [11]. The aforesaid studies on tobacco use among school students have provided evidence that, despite provisions in COTPA and NTCP, tobacco use among children and adolescent is prevalent across India. This suggests the need for further investigation to find the most immediate factors outside the gambit of COTPA responsible for tobacco use among teens, adolescents, and youths. The paper aims to furnish more empirical evidence towards this objective and provide policy inputs which can complement the efforts of the government and civil societies to control the menace of tobacco use. The specific objectives of this paper are to examine the trend in tobacco use including smoking and smokeless tobacco among youths in northeast (NE) India; explore household contextual factor influencing tobacco use among youths; find potential determinants of tobacco; and substantiate the findings in the sociocultural context of the region. The next section of the paper describes data and methods used for this study; it is followed by a section on results highlighting findings and its implications and the paper ends with a section on summary and discussion. spouse and daughter/son in law did not reside in the same households, we take tobacco use status of their parents-inlaw. We could not gather the information regarding parents of 1,297 (4%) youths who are other relatives or nonrelatives of the heads. Therefore, the final sample of the study is reduced to 27,706 youths who are in the age group of 15–24 years. We only consider sample for the usual residents in the households. Finally, mothers and fathers’ use of any tobacco, use of smokeless tobacco, and smoking behaviour is linked with the children data. These parental level variables are in binary form: 1. if they are currently using tobacco; 0, if they are not using or they died or they are not usual residents. If a person consumes (1) pan with tobacco or (2) Gutka/pan masala with tobacco or (3) tobacco only, a person is considered as a user of tobacco, whereas usual smoker (at (...truncated)