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

**Authors:** William J. McCarthy, Ritesh Mistry, Namrata K. Puntambekar, Trivellore Raghunathan, Michael J. Kleinsasser, Maruti B. Desai, Prakash C. Gupta, Mangesh S. Pednekar

PMC · DOI: 10.1186/s12889-025-25035-7 · BMC Public Health · 2025-11-07

## TL;DR

This study explores how religiosity and school connectedness affect the likelihood of adolescents in Mumbai and Kolkata, India, to start using tobacco.

## Contribution

The study is the first to examine the protective effects of religiosity and school connectedness against tobacco use susceptibility among Indian adolescents.

## Key findings

- Adolescents in Mumbai showed stronger associations between prosocial factors and reduced tobacco use susceptibility compared to those in Kolkata.
- Sex-at-birth influenced how prosocial factors affected tobacco use susceptibility.
- Encouraging religiosity and school connectedness may help reduce tobacco use initiation among Indian adolescents.

## Abstract

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.

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.

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.

Encouraging religiosity and school connectedness may help reduce adolescent susceptibility to tobacco use in India.

The online version contains supplementary material available at10.1186/s12889-025-25035-7.

## Full-text entities

- **Species:** Homo sapiens (human, species) [taxon 9606], Nicotiana tabacum (American tobacco, species) [taxon 4097]

## Full text

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## References

16 references — full list in the complete paper: https://tomesphere.com/paper/PMC12595895/full.md

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Source: https://tomesphere.com/paper/PMC12595895