Tobacco use and its association with adverse childhood experiences in adolescents: A cross-sectional study from a school in central India

Background: Tobacco use is the most important modifiable determinant for prevention of noncommunicable diseases. Tobacco use is often initiated during adolescence, and understanding the factors associated with it is vital to prevent initiation. Our objective was to assess the prevalence of tobacco use and its association with adverse childhood experiences (ACE). Materials and Methods: An analytical cross-sectional study was conducted on 200 randomly selected students from a rural school. The World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test tool and WHO ACE international questionnaire were used to assess ever users of tobacco and ACE, respectively. Results: The prevalence of “ever” and “current” use of tobacco was 20.5% (95% confidence interval [CI] = 14.8–26.2) and 14.5% (95%CI = 9.5–19.5), respectively. Majority (65.9%) of the tobacco users had moderate level of tobacco addiction, whereas around 15% had severe addiction. All (100%) the participants had replied in affirmative to at least one of the questions related to the ACEs. On bivariate analysis, male students (prevalence odds ratio [POR] = 10.62, 95% CI = 3.62–31.21]), mothers with <10th grade education (POR = 2.19, 95% CI = 1.08–4.42), parental awareness regarding free time (POR = 0.21, 95% CI = 0.10–0.42), parents not giving enough food even when possible (POR = 5.28, 95% CI = 1.53–18.29), problem drinker in family (POR = 2.12, 95% CI = 1.05–4.29), having divorced or separated parents (POR = 3.26, 95% CI = 1.22–8.74), and being in a physical fight (POR = 2.41, 95% CI = 1.19–4.87) had significantly higher odds of tobacco use. Adolescent boys (adjusted odds ratios [AOR] = 8.42, 95% CI = 2.60-26.60) and parental awareness regarding free time (AOR = 0.40, 95% CI = 0.17–0.94) were the significant predictors for tobacco consumption (P < 0.05) on binary logistic regression. Conclusions: Tobacco use is prevalent among adolescents and is significantly associated with experiencing ACEs.