Tobacco, alcohol use: A multi-city survey led by AIIMS-Delhi has flagged early substance exposure among school-going children, with the average age of initiation around 13 years, prompting researchers to call for prevention efforts starting as early as primary school.
The study, led by Dr Anju Dhawan of AIIMS’ National Drug Dependence Treatment Centre and published this month in the National Medical Journal of India, assessed adolescent substance use across diverse regions. It surveyed 5,920 students from Classes 8, 9, 11 and 12 in urban government, private and rural schools across 10 cities: Bengaluru, Chandigarh, Delhi, Dibrugarh, Hyderabad, Imphal, Jammu, Lucknow, Mumbai and Ranchi. Data were collected between May 2018 and June 2019.
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Researchers reported that the mean age of initiation for any substance was 12.9 years. The earliest initiation was seen for inhalants (11.3 years), followed by heroin (12.3 years) and non-prescription pharmaceutical opioids (12.5 years).
Overall, 15.1% of students reported lifetime substance use, while 10.3% reported use in the past year, and 7.2% reported use in the past month. In past-year use, tobacco (4%) and alcohol (3.8%) were most common, followed by opioids (2.8%), cannabis (2%), and inhalants (1.9%). Among opioid users, non-prescribed pharmaceutical opioids made up the majority of reported opioid use.
The survey also pointed to ease of access. Nearly half of the students (46.3%) felt tobacco products were easily available to people their age, while 36.5% said the same about alcohol. Students also reported perceived access to substances such as bhang, ganja/charas, inhalants, sedatives, opium and heroin, though at lower levels.
Substance use rose with class level, with students in Classes XI/XII twice as likely to report substance use compared with Class VIII students, underlining the need for continued prevention through middle and high school. The study found boys reported higher use than girls across lifetime, past-year and past-month measures.
Family and peer environment also emerged as a key factor. Around 40% of students said a family member used tobacco or alcohol. Smaller proportions reported family use of cannabis and opioids. Students who used substances in the past year were more likely to report substance use among both family members and peers. The survey also noted that about one in four (25.7%) students reported frequent conflicts or fights at home.