Tobacco-use psychosocial risk profiles of girls and boys in urban India: Implications for gender-specific tobacco intervention development

This study examined the distribution of psychosocial risk factors and prevalence of tobacco use among youth in urban India by gender. Data were obtained from a cross-sectional baseline survey of a group-randomized tobacco intervention trial involving 6th and 8th graders from 32 schools in Delhi and Chennai (N = 11,642). Mixed-effects regression models were used to examine differences in the prevalence of tobacco use by gender, to determine how the relationship between current tobacco use and related psychosocial risk factors varied by gender, to compare the distribution of risk factors by gender, and to determine if any of these relationships varied by grade level or school type. 14.7% of girls and 21.1% of boys reported ever-use of tobacco. The psychosocial risk profile for tobacco use was remarkably similar for boys and girls, though some differences were apparent. For example, exposure to advertising and beliefs about social effects of use were significant risk factors for girls but not for boys. Across the board, girls showed lower risk for all psychosocial risk factors, except for perceived prevalence of chewing and smoking, for which girls had higher risk compared with boys. While the psychosocial risk profile for boys suggests a more vulnerable population for tobacco use, the closing gap in tobacco use between boys and girls indicates a need to examine possible differences in psychosocial risk factors. This study reports that there are subtle, but important, differences in risk factors between genders, having implications for gender-specific intervention development.