Effect of school policy on tobacco use by school personnel in Bihar, India.

This study examined the relationship between school tobacco policies and tobacco use prevalence among school personnel. Two subsets of schools were identified in Bihar, India: Federal Schools (with a tobacco policy), and State schools (without a tobacco policy). Stratified probability samples of 50 schools each were selected. The survey was conducted through an anonymous, self-administered questionnaire. School personnel from State Schools (non-policy schools) reported significantly higher daily cigarette smoking and daily current smokeless tobacco use compared to personnel in Federal schools (policy schools). Teachers in State schools did not teach about health consequences of tobacco, and they had not received training for such teaching. Extent of teaching about health consequences of tobacco varied across topics for teachers in Federal schools. They received negligible training, but more than 35% reported access to teaching materials. More than one-half the personnel from Federal schools knew about their school's policy prohibiting tobacco use among students and school personnel, and about policy enforcement. Personnel in State schools did not know about tobacco control policy in their schools. All school personnel in both types of schools were near unanimous in supporting policy prohibiting tobacco use in schools. The study demonstrated an association between enacting a school policy regarding tobacco use and school personnel's use of tobacco, curricular teaching, and practical training of students. Findings suggest that more extensive introduction of comprehensive school policies may help reduce tobacco use among school personnel.