DESCRIPTION (provided by applicant): The goal of this study is to test the efficacy of a comprehensive, community-based tobacco control intervention, among disadvantaged youth (10-19 years) living in low income communities of Delhi. The specific aims of the project are:(1) To conduct a cluster randomized trial, in slum-dwelling and other low income residential communities of Delhi, of non-pharmacologic community led behavioral intervention intended to promote cessation of tobacco use by adolescent consumers of tobacco, in order to evaluate the effectiveness and cost-effectiveness of such interventions; (2) To identify the demographic and psychosocial factors associated with the uptake and cessation of tobacco products by adolescents residing in such communities; (3) To increase the capacity of Indian investigators, research staff, partner NGOs, community leaders and youth self help groups to implement tobacco cessation programs in low resource community settings; (4) To increase the capacity of US investigators to adapt research models and methods validated in developed countries for application in a developing country. Twenty slum clusters of Delhi would be selected to form ten matched pairs, one of each of which would be randomly allocated to a behavioral intervention for tobacco cessation and the other to a control group receiving free eye check-up. The intervention group would receive training for youth peer leaders, adult community leaders and NGO personnel, followed by implementing interactive community based activities that would aim to enhance motivation to quit tobacco use, encourage quit attempts, promote continued abstinence, enhance knowledge around tobacco consumption and tobacco control, develop advocacy skills etc. over a 24 months period. The main outcome measure would compare tobacco cessation rates, between the two trial groups, of young persons (who have remained tobacco free for at least 30 days) and reduce the prevalence rate between the baseline and end- line surveys. Cost-effectiveness (cost per quality-adjusted life year added due to the intervention) would also be assessed. Capacity building activities would include training workshops (for partners and other participants in this research) and preparation of training modules which would be widely disseminated to public health professionals in India. The results of this study are expected to provide information on effectiveness of non-drug community based behavioral interventions for promoting tobacco cessation in disadvantaged youth of low income countries.