Evaluating Knowledge and Attitudes towards Tobacco use among Urban High School Students in Kerala, India: Implications for Targeted Prevention Strategies

Objectives: Adolescence is a critical period marked by susceptibility to increased tobacco, alcohol, and drug use. India, the world's third-largest tobacco consumer and producer, faces rising tobacco use rates, particularly among the youth. This study aimed to assess the knowledge and attitudes regarding tobacco use of high school students in Kerala, India. Methods: A cross-sectional study was conducted in three randomly selected urban high schools in Kerala. Data were collected using a structured questionnaire assessing students' background information, knowledge about tobacco use, and attitudes toward tobacco. Statistical analysis included chi-square tests and t-tests. Results: High school students in Kerala, India, had a moderate understanding of tobacco use, scoring 70.92% on average. They comprehended diseases caused by smoking and smokeless tobacco harms but lacked knowledge about psychological and social effects and treatment options. Attitudes varied, with 55.9% favoring tobacco control and 44.1% opposing. Significant factors affecting knowledge and attitudes included family type, parental tobacco use, perceived economic status, and age. Nuclear families, non-tobacco-using parents, better economic status, and older age correlated with higher knowledge and more favorable attitudes. Conclusion: Understanding the factors is essential for designing targeted interventions and prevention programs to promote healthier attitudes towards tobacco use among high school students. Tailored interventions should consider age-specific needs, parental involvement, and economic factors to effectively combat tobacco use among adolescents.