Religiosity, school connectedness, and tobacco use susceptibility: a longitudinal study of adolescents in Mumbai and Kolkata, India.

BACKGROUND: Religiosity and school connectedness have been shown to protect adolescents from tobacco use initiation in the U.S. and Europe but have not been examined in India. A population-based in-home survey of 1,982 adolescents' susceptibility to tobacco use in India was examined in relation to several adolescent prosocial factors: connectedness with school, and three indicators of religiosity. METHODS: Religiosity measures included participant frequency of attendance at places of worship (e.g., mosque, temple), frequency of prayer, and importance of prayer. School connectedness measures included feeling like you are a part of the school, you are happy at your school, and you feel safe at your school. Primary outcome was susceptibility to tobacco use defined as intention to or openness to using tobacco during next 12 months. RESULTS: More in Mumbai than in Kolkata, adolescent prosocial factors were associated with reduced susceptibility to tobacco use. Adolescents' sex-at-birth also influenced these associations. CONCLUSION: Encouraging religiosity and school connectedness may help reduce adolescent susceptibility to tobacco use in India.