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Am J Public Health. 2013 Nov;103(11):2035-40. doi: 10.2105/AJPH.2013.301303. Epub 2013 Sep 12.

Effects of a tobacco control intervention for teachers in India: results of the Bihar school teachers study.

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Glorian Sorensen, Eve Nagler, and Kasisomayajula Viswanath are with the Dana-Farber Cancer Institute, and the Harvard School of Public Health, Boston, MA. Mangesh S. Pednekar and Prakash C. Gupta are with the Healis-Sekhsaria Institute of Public Health, Navi-Mumbai, India. Dhirendra N. Sinha is with the School of Preventive Oncology, Patna, Bihar, India. Anne M. Stoddard is with New England Research Institutes, Watertown, MA. Mira B. Aghi is a consulting behavioral scientist, New Delhi, India. Harry A. Lando is with the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis. Pratibha Pawar is with Healis-Sekhsaria Institute for Public Health, Navi-Mumbai, India.



We assessed a school-based intervention designed to promote tobacco control among teachers in the Indian state of Bihar.


We used a cluster-randomized design to test the intervention, which comprised educational efforts, tobacco control policies, and cessation support and was tailored to the local social context. In 2009 to 2011, we randomly selected 72 schools from participating school districts and randomly assigned them in blocks (rural or urban) to intervention or delayed-intervention control conditions.


Immediately after the intervention, the 30-day quit rate was 50% in the intervention and 15% in the control group (P = .001). At the 9-month postintervention survey, the adjusted 6-month quit rate was 19% in the intervention and 7% in the control group (P = .06). Among teachers employed for the entire academic year of the intervention, the adjusted 6-month abstinence rates were 20% and 5%, respectively, for the intervention and control groups (P = .04).


These findings demonstrate the potent impact of an intervention that took advantage of social resources among teachers, who can serve as role models for tobacco control in their communities.

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