Awareness regarding secondhand smoke and its related legislation (cigarettes and other tobacco products act) among school-going adolescents in district Kullu of Himachal Pradesh, India

Abstract

Background: The consumption of tobacco causes maximum health damage, worldwide. Secondhand smoke (SHS) exposure is
associated with serious health problems, especially in adolescents. The “cigarettes and other tobacco products act (COTPA)” has
been formulated by GOI to reign in this epidemic. Hence, the present study was undertaken to access the awareness on SHS and
its related legislation COTPA. Material and Methods: The present study was a descriptive school-based cross-sectional study
conducted among students (13-19 years) studying in classes 8-12th carried out in Kullu district. Multistage cluster random design
and probability proportional to size sampling methodology was adopted. A sample of 900 students both from rural and urban
areas studying in 10 government and private senior secondary schools was selected. An anonymous, pretested, self-administered
questionnaire was used to collect relevant information. Proportions, percentages, and odd’s ratio were calculated for relevant
variables. Results: Around 35.1% were exposed to SHS at home. Nearly, 71.1% perceived it to be harmful for health, among which
it was highest (46.9%) for cancer followed by respiratory disease (39.7%). Overall awareness about COTPA was 29.8%. Participants
who were studying in private schools (odds ratio [OR] 2.15, 95% confidence interval [CI]: 1.08-4.26), whose fathers were highly
educated (OR 2.20, CI: 1.15-4.21), whose mothers were highly educated (OR 2.31, 95% CI: 1.56-4.61), whose friends smoked (OR 1.84,
95% CI: 1.03-3.29), and who were themselves smokers (OR 5.60, 95% CI: 2.78-11.29), all were more likely to have good awareness
of COTPA. Conclusion: There was high knowledge about deleterious effects of self and SHS among the participants. The findings
however reveal a subpar level of knowledge regarding COTPA. Concerted efforts should be made to increase the awareness of
COTPA focusing on adolescents involving all the stakeholders.