Cigarette use and exposure to second-hand smoke and tobacco advertising among Tunisian adolescents.

Abstract

The Global Youth Tobacco Survey was conducted in Tunisia in 2001, 2007, 2010 and 2017. It is the only national survey that examined exposure to second-hand smoke and tobacco advertising among young people, and there has been no description of the trend. To describe cigarette use trends among Tunisian adolescents and their exposure to second-hand smoke and tobacco advertising from 2001 to 2017. The Global Youth Tobacco Survey is a school-based cross-sectional survey conducted by the World Health Organization. It uses a two-stage cluster sampling design to obtain a representative sample of students aged 13-15 years. A standardized questionnaire is used for data collection. We compared the prevalence and 95% confidence intervals (CI) of ever and current cigarette use, exposure to second-hand smoke in and outside the home, and exposure to tobacco advertising, over 4 years (2001, 2007, 2010 and 2017). Current cigarette use decreased from 11.1% (95% CI: 10.0-12.3%) in 2001 to 7.7% (95% CI: 6.5-9.0%) in 2017 (P < 0.001). Exposure to second-hand smoke at home decreased from 62.5% (95% CI: 60.7-64.2%) to 46.7% (95% CI: 44.5-49.0%) over the same period (P < 0.001), but exposure outside the home increased from 65.4% (95% CI: 63.7-67.1%) in 2001 to 73.3% (95% CI: 71.2-75.3%) in 2017 (P < 0.001). Exposure to anti-tobacco messages in the media decreased from 87.8% (95% CI: 86.3-89.1%) in 2001 to 64.4% (95% CI: 62.2-66.5%) in 2017 (P < 0.001). While the prevalence of cigarette use and second-hand smoke exposure at home decreased, exposure outside the home increased. Efforts are needed to ensure compliance with smoke-free laws to decrease the prevalence of exposure to second-hand smoke.