Publication:

Awareness, attitudes and practices regarding tobacco and the effectiveness of a school-based educational intervention among rural school children in Maharashtra, India

Background Tobacco use remains a leading cause of preventable morbidity and mortality worldwide, with adolescents being particularly vulnerable to initiation. In India, rural areas report higher tobacco use prevalence, necessitating targeted interventions. This study evaluates the effectiveness of a school-based educational intervention in improving awareness of tobacco-related health effects among 12 to 16 years old schoolchildren in a rural setting.

Methods A pre-post educational interventional study was carried out among 236 schoolchildren in a rural area of Maharashtra. Baseline awareness attitudes and practices were assessed using a pre-validated questionnaire, followed by a structured educational intervention incorporating interactive audio-visual aids. Post-intervention assessments were conducted immediately and after three months. Knowledge and attitude changes were analysed using the Wilcoxon signed-rank test.

Results Baseline knowledge about tobacco was high (94.5%), but misconceptions persisted regarding its health effects and legal regulations. Post-intervention, the proportion of schoolchildren with excellent knowledge (>70% score) increased from 40.7% to 48.7% in the immediate post-test but slightly declined to 45.5% at three months. Similarly, schoolchildren with an excellent attitude towards tobacco prevention improved from 66.9% at baseline to 71.4% at three months. The intervention significantly improved awareness and attitudes (p<0.05), but retention declined over time, highlighting the need for reinforcement.

Conclusions The educational intervention significantly enhanced schoolchildren' knowledge and attitudes toward tobacco use and its health effects. However, knowledge retention declined after three months, underscoring the importance of periodic reinforcement. Integrating structured tobacco education into school curricula and involving parents in awareness programs could enhance the long-term impact.