Testing the effectiveness of a teacher-training intervention to make schools tobacco-free in India: Results from a quasi-experimental post-only study

Abstract

Introduction Tobacco-free schools (TFS) are critical for preventing tobacco-use among adolescents, who constitute nearly 21% of India’s population. This study tested the effectiveness of a teacher-training intervention for achieving tobacco-free schools in the state of Maharashtra in India. Methods A quasi-experimental post-only study was conducted in four districts in Maharashtra state. Starting in 2013, designated teachers from 2188 government schools in two intervention districts received a day-long tobacco-free school training intervention each year for five years. About 1707 similar schools in two comparison districts did not receive the intervention. At the end of five years, in 2018, we assessed adherence to 11 TFS criteria by visiting randomly selected schools in the intervention and comparison districts. Results In intervention districts, 37.8% (34) of visited schools fulfilled all 11 TFS criteria, 34.4% (31) fulfilled 7–10, and 27.8% (25) schools fulfilled ≤6 criteria. This was significantly (p<0.001) higher than in comparison schools, where none fulfilled all 11 criteria, 13.2% (9) met 7–10, and 86.8% (59) fulfilled ≤6 criteria. Conclusions The TFS intervention achieved 100% fulfillment in nearly two out of five schools, with another one in three schools fulfilling 7–10 criteria; in contrast, 4 out of 5 schools in the comparison districts fulfilled ≤6 criteria. The proportion of tobacco-free schools can be increased and the process accelerated in rural districts by adding more components to the existing teacher training intervention.

Keywords

• tobacco
• adolescents
• tobacco-free schools (tfs)
• tobacco policy implementation
• india