Factors associated with tobacco smoking among 6-10 grade school students in an urban Taluka of Sindh

Objective: To determine the factors related to tobacco smoking among students of grade 6-10 in an urban setting in Sindh, Pakistan. Study Design: Cross-sectional survey. Place and Duration of Study: The study was conducted in public and private schools of Hyderabad, Sindh, Pakistan, from January 2008 to June 2009. Methodology: A sample of 501 students from grade 6-10 were selected through simple random sampling and probability proportional to size. Students answered to a pre-tested questionnaire on sociodemography and tobacco use. Descriptive statistics were used to determine frequency distribution. Results: About 9% of the students were smoking some form of tobacco. Ten percent had tried cigarette smoking and about 80% and 61% were chewing Areca nuts and 'Paan' (concoction of Areca nuts, tobacco, hydrated lime, herbs and spices wrapped in betel leaf. Being old, male gender, peer influence, personal attitude toward future smoking, chewing 'Gutka' (concoction of tobacco, Areca nuts and hydrated lime) and having a more educated mother was associated with greater frequency of smoking any form of tobacco. Conclusion: High frequency of tobacco smoking, the attitude toward tobacco consumption and a very high consumption of Areca nuts and other chewable tobacco products by the children warrants urgent action in order to control the tobacco epidemic in Pakistan.