Study shows school-based life skills tobacco control program can lower smoking rates in youth

April 19, 2012

A new study provides the latest evidence that school-based tobacco control programs can have a positive effect in lowering tobacco use among youth. The study was an evaluation of Salaam Bombay Foundation’s (SBF) life-skills tobacco control project for youth of low socioeconomic status in Mumbai, India, and neighboring parts of Maharashtra.

Researchers at Harvard School of Public Health and Dana Farber Cancer Institute in Boston, Mass., and Healis Seksharia Institute for Public Health, Mumbai, found that students in SBF project schools were half as likely to use tobacco as students from schools not enrolled in the program. The study appeared online on April 16, 2012, in the journal PLoS One. The findings from this study are strongly supported by the findings of the 31st US Surgeon General Report which concluded that coordinated, multi-component interventions that include mass media campaigns, community programs and school-based policies are effective in “preventing onset and use of tobacco use among youth and young adults.”

Currently, an estimated 5 million children in India are addicted to tobacco. Uneducated youth and those with a lower socio-economic status have higher levels of tobacco consumption because of easy availability of tobacco and lack of social sanctions. The goal of SBF’s tobacco control program is to reduce tobacco use initiation and prevalence in youth by improving their personal and social competence to deal with tobacco challenges. SBF runs a two-year tobacco program. In the first year the program focuses on awareness building in 8th graders. In the second year, the program builds on the skills imparted in the first year by providing advocacy training.

“Salaam Bombay Foundation’s tobacco control project is a unique program that teaches personal and social skills that foster self confidence and create positive role models in youth,” said its director, Padmini Somani. “Through the program, youth not only remain tobacco-free but also become strong tobacco control advocates.”

During the period covered by this study, SBF provided in-school programming to almost 50,000 children between the ages of 10 and 17 across 147 government-run schools in Mumbai. Using a quasi-experimental design, the researchers compared the effectiveness of SBF’s program by comparing 8th and 9th grade students in intervention schools to 8th grade students in comparable schools that did not receive the program. Researchers compared tobacco use rates between 36 SBF intervention schools and 23 control schools.

The findings show:

  • Fewer students in SBF schools were likely to smoke (4.1%) compared to students in the control schools (8.7%)  after the first year of the program. The difference between the tobacco use in intervention and control schools was even more significant in the second year (3.4% vs. 8.7%).
  • More students in intervention schools were knowledgeable about tobacco control laws, including the law that prohibits individuals smoking in public places and the law that prohibits sale of tobacco products to minors.
  • SBF school students were 5-10 percent more confident of being able to help individuals refuse tobacco.

According to the authors, this study is among the first to demonstrate the impact of life-skills intervention for tobacco use prevention among youth in India. “The findings of our study provide evidence that school-based tobacco programs that build life skills among students from low socioeconomic status significantly reduce initiation of tobacco use,” said author Prakash Gupta, director of Healis-Sekhsaria Institute of Public Health.

Lead author, Glorian Sorensen, professor of society, human development, and health at Harvard School of Public Health, said, “These findings underscore the substantial impact of a broad-based program on the tobacco use patterns of low income children in India.”

For more information contact Glorian Sorensen at or (617) 632-2183.