Abstract P137: Smoking Susceptibility and its Predictors among Nepalese Adolescents: Evidence from the Jhaukhel- Duwakot Health Demographic Surveillance Site, Bhaktapur District, Nepal

Abstract

Introduction: Cognitive susceptibility to smoking is defined as absence of firm commitment not to smoke in the future or if offered a cigarette by best friends. It begins in adolescence and is the first step in the transition to current smoking. Psychosocial risk factors play a crucial role to discourage susceptible adolescents from becoming established smokers. Most studies were conducted in the USA and evidence from low-income countries is limited. Despite the established Tobacco Product Control and Regulatory Bill 2011S in Nepal, cigarette smoking is widely prevalent among adolescents and the absolute number of smokers continues to rise. Hypothesis: We tested the hypothesis that socio-demographic and environmental risk factors associated with susceptibility to smoking among adolescents living in a peri-urban area of Nepal. Methods: We conducted a community cross-sectional study during October-November 2011 in the Jhaukhel - Duwakot Health Demographic Surveillance Site, a peri-urban area in Bhakapur district, 13 km east of the capital Kathmandu in Nepal, where tobacco products are easily available to adolescents. Trained local enumerators conducted face-to-face interviews with 352 randomly selected 14-16 year old non-smoking adolescents. The Nepal Health Research Council and Ethical Committee of Kathmandu Medical College approved this study. Results: The percentage of smoking susceptibility was 49.70% (95% CI: 44.49%-54.93%). In univariate analysis, sex, family members/relatives smoke, teacher smokes, friend smokes, exposure to secondhand smoke, participation in picnic/concerts, exposure to tobacco advertisements, and having seen actors smoke were associated with susceptibility to smoking. While in multiple regression analysis, smoking behavior of family members/relatives, teacher smoking, exposure to pro-tobacco advertisements and involvement in picnic/concerts were associated with susceptibility to smoking. Conclusion: Our results reveal that non-smoking adolescents, depending on their socio-demographic and environmental backgrounds, consider smoking initiation risk factors differently. We therefore suggest that future smoking intervention programs should also take socio-environmental influences into account for efficiently preventing non-smoking adolescents becoming susceptible to smoking.