The attendance paradox: schools as ambivalent spaces of adolescent substance use

Background

Adolescent substance use in India has become a significant public health challenge. It is increasingly characterized by a shift toward easily concealed smokeless tobacco pouches ("Cool Lip") and inhalants, which fall outside awareness-based school prevention frameworks. School absenteeism has been identified in the global literature as the key behavioral indicator of adolescent substance use, based on the assumption of a relatively stable home environment. This assumption may not hold in low-income urban government schools in India, where the Right of Children to Free and Compulsory Education (RTE) Act, 2009, legally requires that every child enrolled be retained. This study investigates this question from the perspective of government school teachers. Methodology: Semi-structured in-depth interviews were conducted with twenty-one government school teachers, headmasters, and physical education instructors across 16 schools in Chennai district, Tamil Nadu, India. Data were analyzed using reflexive thematic analysis in combination with a six-step conceptual model development process, with theoretical frameworks introduced only after the inductive generation of themes.