Background: This paper compares tobacco use patterns and tobacco use prevention efforts among teachers in two Indian states with high versus low prevalence of tobacco use.
Methods: Data from the Global School Personnel Survey compared tobacco use patterns and tobacco use prevention activities among teachers from the Indian states of Maharashtra (N = 954) and Bihar (N = 524).
Results: 78% of teachers in Bihar and 31% from Maharashtra were current tobacco users. Tobacco control policies were virtually non-existent in schools in Bihar, while in Maharashtra, over one-fourth of teachers reported that tobacco use was prohibited among both students and teachers. Few teachers in Bihar taught their students about tobacco use prevention, while such teaching was more common in Maharashtra. In Maharashtra, teaching about tobacco use prevention was significantly associated with not currently using tobacco (P < 0.0001), having a policy specifically prohibiting tobacco use among students (P < 0.0001), and having a policy specifically prohibiting tobacco use among school personnel (P < 0.0001).
Conclusions: This study has clear implications for implementation of tobacco control policies in Indian schools and further underscores the need for infrastructure support for tobacco use prevention in developing countries such as India, where tobacco use threatens to contribute to a growing proportion of the burden of disease worldwide.