Social contextual factors and tobacco use among Indian teachers: Insights from the Bihar School Teachers' Study

Eve M. Nagler, Dhirendra N. Sinha, Mangesh S. Pednekar, Anne M. Stoddard, Prakash C. Gupta, Neha Mathur, Harry Lando, Mira Aghi, Laura Shulman Cordeira, K. Viswanath, Glorian Sorensen

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Objective: Tobacco use within India has significant effects on the global burden of tobacco-related disease. As role models and opinion leaders, teachers are at the forefront of tobacco control efforts, yet little is known about their own tobacco use. This study examines the association between factors in the social environment and tobacco use among teachers in Bihar, India. Methods: The study was based on the Bihar School Teachers' Study baseline survey. Seventy-two Bihar government schools (grades 8-10) were randomly selected for the study and all school personnel were invited to complete the survey in June/July in 2009 and 2010. We assessed the relation between social contextual factors and current smoking/smokeless tobacco use by fitting a series of logistic regression models. Results: After controlling for clustering of teachers in schools and other covariates, our results showed teachers with one or more coworkers who used tobacco were twice as likely to be smokeless tobacco users as teachers with no co-workers who used tobacco. Teachers who reported rules prohibiting smoking at home were significantly less likely to smoke than teachers without such rules. Older male teachers also had significantly greater odds of smoking/using smokeless tobacco. Conclusion: These findings provide direction for future interventions targeting the social context.

Original languageEnglish (US)
Pages (from-to)24-30
Number of pages7
JournalPreventive medicine
StatePublished - May 1 2015

Bibliographical note

Funding Information:
This work was supported by the National Institutes of Health [grant numbers 5R01 CA120958-05 to G.S. and 5 K05 CA108663 to G.S.].

Publisher Copyright:
© 2015.

Copyright 2015 Elsevier B.V., All rights reserved.


  • Co-workers
  • Family influence
  • India
  • Schools
  • Social context
  • Teachers
  • Tobacco use

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