Background:
Growing influence of tobacco among youth in developing countries has necessitated evaluation of social and behavioral factors responsible for the phenomenon. Mangalore taluk is a reputed health care center in Karnataka state, India, with high levels of urbanization and literacy. This investigation evaluated social and behavioral determinants of tobacco use among children of public and private high schools in urban and rural areas of Mangalore taluk.

Methods:
Study participants were enrollees of ten high schools selected by stratified cluster sampling. After obtaining ethical clearance, permission from concerned authorities and assent from participants, a pre-tested questionnaire was used to collect data on current use, reason for initiation, funding for habit, source of tobacco, difficulty in procurement, changes in lifestyle and health, knowledge about ill-effects, etc. Data were analyzed using the Chi squared test.

Results:
Current tobacco use was prevalent among 12.8% of the 1340 participants aged between 11-18 years. Evaluation of responses revealed no significant differences based on type of school or location; however, gender differences among participants were pronounced. Among users, girls reported higher use of smokeless tobacco, higher frequency of daily use, and use by family members as primary reason for initiation into habit. A significant number of users had initiated use in the past year, 35.7% stated use by family as reason for initiation, a majority reported funding of habit by allowances from family, and 73.7% reported no difficulty in procurement from vendors near public facilities. While 88.9% considered the habit dangerous and 31.6% wanted to stop use, 20% reported an increased self-esteem. Among non-users, 84.1% reported availability of tobacco for use. Among both categories, predominant source of knowledge on ill-effects of use was the print media.

Conclusions:
Rising tobacco consumption among girls and easy availability of tobacco for use among adolescents are a cause for concern.