Background: Adolescent tobacco use remains a significant public-health concern in India, particularly in Mizoram, a predominantly tribal Northeastern state with one of the highest tobacco consumption and cancer incidence rates in the country. Early initiation of tobacco use increases the risk of nicotine dependence and tobacco-related chronic diseases later in life. Despite national tobacco-control initiatives, limited evidence exists on how demographic and school-related factors influence tobacco-use behaviours among tribal adolescents.
Objective: To assess the prevalence of smoked and smokeless tobacco use and examine behavioural patterns related to initiation, continuation and cessation intentions among school-going adolescents in Mizoram.
Methods: A cross-sectional study was conducted among 6,626 students aged 12–20 years from government and private schools in Mizoram. Data were collected using a validated structured questionnaire capturing demographic characteristics and tobacco-use behaviours. Descriptive and logistic regression analyses were performed to examine differences by age, gender and school type.
Results: Among the participants, 48.5% were male and 51.5% were female, with most students aged 16–19 years. Smoking prevalence was higher among boys, whereas smokeless tobacco use, particularly chewing tobacco, was more common among girls. Tobacco use increased with advancing grade level and was highest among students in classes 11 and 12. Boys were more likely to discontinue smokeless tobacco use with age, while girls tended to continue. Overall tobacco use was higher among students attending private schools. Cigarette smoking and chewing tobacco were considerably more prevalent than liquid tobacco products.
Conclusion: Tobacco use is highly prevalent among tribal adolescents in Mizoram, with clear gender- and school-type differences. These findings highlight the need for culturally appropriate, school-based prevention strategies and gender-responsive interventions to reduce early tobacco initiation and long-term health risks.
