Introduction : Tobacco usage is a major global health issue, particularly in low- to middle-income countries like India. Early initiation, especially among school-aged children, increases the risk of tobacco-related morbidity and mortality. Understanding tobacco use prevalence and patterns among youth can help shape effective interventions. We aimed to assess the prevalence and patterns of tobacco use among 9th to 12th-grade school students in the Ernapuram Block of Namakkal, Tamil Nadu.
Methods : This cross-sectional study surveyed 300 students in December of 2023, allowing them to disclose tobacco use through either a written questionnaire or a confidential in-person interview. Data were analysed using descriptive and statistical methods to determine prevalence and differences in disclosure rates.
RESULTS: Among the 300 students surveyed, 63 (21%) reported tobacco use, with 51 male and 12 female users. Confidential settings led to higher disclosure rates, particularly among female students (p-value < 0.05). Smokeless tobacco was the most common form, used by 76% of users, with an average initiation age of 13–15 years. A majority (56%) reported using tobacco more than five times weekly, with an average tobacco use duration of 3.37 years.
CONCLUSION: This study underscores a high prevalence of tobacco use among school students, particularly smokeless forms, with early initiation and frequent use patterns indicating dependency. Confidential interviews were more effective than questionnaires for disclosure, especially among girls. Targeted education on tobacco risks and long-term health impacts are essential to address this growing issue.