Is Tobacco Use Associated With Academic Failure Among Government School Students in Urban India?

METHODS: This study was a secondary analysis of data gathered from students in 7 government schools during a larger tobacco intervention trial in India. Mixed-effects regression analyses were carried out on a cross-sectional sample of 3799 students and a retrospective cohort of 2586 students. Data on tobacco use and risk factors were collected from self-reported student surveys in 2006 and 2004. Using school records, academic failure was defined as repeating the same grade level once or twice between 2004 and 2006. RESULTS: In 2006, academic failure was significantly more prevalent among students who reported use of chewing tobacco, bidis, or cigarettes, as compared with nonusers. Students with academic failure had greater social susceptibility and intentions for future tobacco use, and poor knowledge and self-efficacy for avoiding tobacco. Cohort analyses showed that students who had reported tobacco use in 2004 were more likely to have academic failure by 2006, as compared with nonusers. CONCLUSIONS: School health programs that incorporate tobacco control measures should be offered to government school students with poor academic outcomes in India, along with remedial education efforts. School-based longitudinal research is needed to assess effects of tobacco use in early adolescence on academic, social, and behavioral outcomes in later adolescence and young adulthood.