Perception of tobacco use among school-going early adolescent children in Udupi District: A cross-sectional study

Background: Tobacco use among school-going children is a significant public health concern worldwide. Studies on perception and knowledge about harmful effects of tobacco use among early adolescent children are limited. Aim: To assess the knowledge, attitude, and perception of tobacco use among rural and urban school-going early adolescent children. Methods: A cross-sectional study design was used. Using mixed method multi-stage sampling, a sample of 218 eighth grade students were selected randomly using the simple random technique from two government schools (rural and urban schools were chosen purposively), Udupi district, Karnataka. Data were collected using the questionnaire method. The Global Youth Tobacco Survey was used for the data collection. Descriptive statistics were used to express the data and Chi-square test and Fisher's exact test were used to compare the categorical variables. Results: More than one-third (39%) of middle school children have used tobacco in the past. About 44% of boys felt guilty about their tobacco use. About two percent tried using other forms of tobacco products. Less than 1% of them had used tobacco more than once in the past 30 days. Urban children had significantly more knowledge about the harmful effects of tobacco use (p = .001), quitting tobacco (χ2 = 11.6, p = .008), and reasons for quitting tobacco use was, noticing anti-tobacco messages. More urban children think using tobacco makes boys more attractive (χ2 = 9.07, p = .01) and girls more attractive (χ2 = 10.80, p = .004). Conclusion: The prevalence of tobacco use was 1.5% among middle-school children in the last month. Urban school children have significantly more knowledge and awareness about the harmful effects of tobacco use than rural students.