Protocol for a feasibility study of longitudinal surveys to assess the impact of policies on tobacco use among school-going adolescents in South Asia

Romaina Iqbal*, Masuma Pervin Mishu, Kamran Siddiqi, Ann McNeill, Mona Kanaan, Cath Jackson, Rumana Huque, Sushama Kanan, S. M. Abdullah, Fariza Fieroze, Suneela Garg, M. Meghachandra Singh, Amod L. Borle, Chetana Deshmukh, Zohaib Akhter, Laraib Mazhar, Zohaib Khan, Khalid Rehman, Safat Ullah, Lu HanAnne Readshaw

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Smokeless tobacco (ST) use is common among youth in South Asia where 85% of the world's 300 million ST users live and use the most lethal ST forms. Little is known about the impact of tobacco control policies on the youth ST uptake in those countries. We planned to conduct longitudinal surveys among school going adolescents to evaluate existing tobacco control policies on tobacco uptake and use, and a feasibility study for that prospective, observational cohort study. Study objectives: (1) To demonstrate the feasibility of selection, recruitment and retention of schools and of study participants; (2) To assess the feasibility and acceptability of the study procedure and study tool (questionnaire); (3) To evaluate if the questionnaire can assess tobacco uptake and use, and their potential predictors. Methods and analysis: The feasibility study will be conducted in two administrative areas within each of three South Asian countries: Bangladesh, India and Pakistan. We will use both quantitative and qualitative data collection methods. Eight eligible schools will be randomly selected within purposively selected sub-districts from each country. We plan to conduct one baseline and one follow up survey among students of grade 6-8, one year apart. At each time point, data on tobacco uptake and potential predictors will be collected from students via self-administered questionnaires that were designed for the longitudinal study. The qualitative component will be embedded into the study with each round of data collection to assess the acceptability of the study instrument (questionnaire) and data collection methods, via focus group discussions with students and semi-structured interviews with schoolteachers. Recruitment and retention rates, completeness of the questionnaires, frequencies and associations of tobacco use and explanatory variables will be reported. Data gathered from the focus group and interviews will be analysed using the framework approach.

Original languageEnglish
Article number1123
Publication statusPublished - 1 Mar 2022

Bibliographical note

Funding Information:
Other members of ASTRA-Youth team, Ravi Kaushik, Nidhi Bhatnagar, special thanks to senior advisory members- Aziz Sheikh, Paramjit Gill, Jagdish Kaur, and ASTRA International Advisory Board members- Mark Parascandola, Jasjit Ahluwalia, Nigar Nargis, Sohel Choudhury, and the Co-Director of ASTRA Ravi Mehrotra.

Publisher Copyright:
© 2022 Mishu MP et al.


  • Adolescents
  • Feasibility
  • Longitudinal study
  • Secondary school students
  • Smokeless tobacco

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