 Objective

The Global Youth Tobacco Survey (GYTS) is a worldwide

collaborative surveillance initiative that includes governments and
non-governmental organizations under the leadership of the World
Health Organization/Tobacco Free Initiative (WHO/TF) and the
US Centers for Disease Control and Prevention/Office on Smoking
and Health (CDC/OSH). The GYTS was developed to enhance the
capacity of countries to design, implement, and evaluate tobacco
control and prevention programmers. Methods: The GYTS
employs a standard methodology where self-administered
questionnaires, consisting of a set of core questions, are completed
by a representative school-based sample of students primarily
between the ages of 13-15 years. Results: Data are presented from
75 sites in 43 countries and the Gaza Strip/West Bank region.
Current use of any tobacco product ranges from 62.8% to 3.3%,
with high rates of oral tobacco use in certain regions. Current
cigarette smoking ranges from 39.6% to less than 1%, with nearly
25% of students who smoke, having smoked their first cigarette
before the age of 10 years. The majority of current smokers want to
stop smoking and have already tried to quit, although very few
students who currently smoke have ever attended a cessation
programmed. Exposure to advertising is high (75% of students had
seen pro-tobacco ads), and exposure to environmental tobacco
smoke (ETS) is very high in all countries. Only about half of the
students reported that they had been taught in school about the
dangers of smoking during the year preceding the survey.
Conclusions: Global youth tobacco use is already widespread
throughout the world, but there is great variation among nations.
Valid and reliable data on the extent of youth tobacco use, and
correlates of use, are essential to plan and evaluate tobacco use
prevention programs. The GYTS has proven the feasibility of an
inexpensive, standardized, worldwide surveillance system for
youth tobacco use. The GYTS will be expanded to the majority of
countries in the next few years, and can serve as a baseline for
 monitoring and evaluating global and national tobacco control
efforts.

 Change in tobacco use among 13–15-year-olds between 1999

and 2008: Findings from the Global Youth Tobacco Survey

Tobacco use is the leading preventable cause of death and disease in

the world; yet little is known about the levels or patterns of youth
tobacco use on a global basis. The purpose of this paper is to focus on
change in youth tobacco use using data from 100 sites that have
conducted repeat Global Youth Tobacco Surveys (GYTS). The GYTS
is a school-based survey that collects data from students aged 13–15
years using a standardized methodology for constructing the sample
frame, selecting schools and classes, and processing data. GYTS is
conducted in school classes using self-administered anonymous data
collection. The GYTS sample produces representative, independent,
cross-sectional estimates for each sampling frame. Of the 100 sites
surveyed, 61 reported no change over time in prevalence of cigarette
smoking, likewise in 50 of the 97 sites with data on use of other
tobacco products there was no change. However, 34 sites reported an
increase in other tobacco use. This appears to be attributed to
waterpipe, an emerging trend in tobacco use. Evidence was found
supporting the idea that tobacco use among adolescent girls is likely
increasing. The global tobacco control effort continues to face many
challenges in reversing the tobacco epidemic. Few countries have
implemented comprehensive tobacco control legislation laid out by
the World Health Organization. The few countries that have adopted
some of these proven policies can serve as examples in achieving
positive results in curbing the tobacco epidemic. (Global Health
Promotion, 2009.
  Tobacco Use among Students and School Personnel in India

Background: Tobacco usage is addictive and causative for

several diseases and premature death. Concerted efforts by the
individual and society are needed for control and for
surveillance. The habit is initiated during early youth and this
age group requires constant monitoring and timely appropriate
action to curtail usage. The WHO FCTC has recommended
actions to monitor and limit the tobacco use in young age
groups. One of the actions is to examine the prevalence of
tobacco habits in school children 13-15 years of age and of
personnel employed in schools.

Methods: WHO & CDC designed the study systems for Global
Youth Tobacco Survey (GYTS) and Global School Personnel Survey
(GSPS). In 2006 we conducted GYTS and GSPS in several parts of
the country. The schools were chosen by strict sampling procedure
and a well-structured, self-administered questionnaire was used to
obtain information on tobacco usage from 13- to 15-year-old students
of chosen schools and personnel of these schools.

Results: Current use of any tobacco product was 14.1% among

students (17.3%boys, 9.8% girls) and among school personnel it was
29.2% (35.0% males and 13.7% females). The prevalence was highest
among male students in North East (34%) and the lowest was 4.9%
among female students of western states. Cigarettes and Bidi smoking
were more prevalent among boys. Smokeless tobacco uses prevalence
rate varied between 20% and 4.5% among boys and between 21.5%
and 1.6% among girl students. Among Male school personnel, the
prevalence varied from 57.9% in NE to 25.7% in South. Among
females 26.5% were tobacco users in the NE and in Western region it
was 6.6%.

Conclusion: It is essential to adopt forceful strategies, which are area

specific, in order to undo the harm inflicted by tobacco use upon the
individuals & society. Periodic surveys for surveillance of trends are
essential to evaluate the outcome of programs among students and
school personnels.

 A Survey of 24,000 Students Aged 13–15 Years in India:

Global Youth Tobacco Survey 2006 and 2009
Background
Students aged 13–15 years in Grades 8–10 have been surveyed in the
year 2006 and in 2009 to monitor the prevalences of smoking and
smokeless tobacco use and to assess their attitudes, knowledge and
behaviors towards tobacco use and its health impact.

Methods
The Global Youth Tobacco Survey is a cross sectional survey that
uses a two-stage cluster sample design to get a representative sample
of schools and students for the study. In India, a total of 12 086
students in the year 2006 and 11 768 in 2009 were surveyed.

Results
About 14% (13.7% in 2006 and 14.6% in 2009) of students use
tobacco (smoking/smokeless tobacco). The prevalence of smoking
among boys is about three times that of girls in both the surveys. The
prevalence of smokeless tobacco among girls is twice that of smoking
tobacco in both the surveys. In the 2009 survey comparing with the
2006, the percentage of students who initiated bidi smoking before 10
years of age is significantly higher in boys (2006: 26.0% and
2009:45.4%); the percentage of never smokers likely to initiate
smoking in the following year is significantly lower in girls (2006:
16.0% and 2009: 10.8%); the percentage of students exposed to
smoke from parents is significantly lower (2006: Boys-38.3%, Girls-
30.7% and 2009: Boys-29.3%, Girls-22.4%); the percentage of
students who reported that they were taught about the dangers of
smoking during the school year is higher; and, ever smokers received
help or advice to help stop smoking is significantly higher (2009:
19.5% and 2006: 4.4%). The percentage of students who saw any
advertisements for tobacco, the percentage of students offered free
cigarettes by a cigarette company representative or their
access/availability to smoking tobacco and the changes observed in
the prevalences of tobacco use among students in 2009 is not
significantly different from 2006.

Conclusions
No significant difference is seen in the prevalence of tobacco use
among students between the 2006 and 2009 surveys. The percentage
of boys who initiated bidi smoking before age 10 is statistically higher
in 2009 compared to 2006. There is a need to strengthen enforcement
of policies already in place as well as focus on expansion into
additional program efforts.