Correlates of smoking susceptibility among adolescents in a peri-urban area of Nepal: a population-based cross-sectional study in the Jhaukhel-Duwakot Health Demographic Surveillance Site

Umesh R Aryal,Max Petzold,Göran Bondjers,Alexandra Krettek

doi:10.3402/gha.v7.24488

Abstract

BackgroundSusceptibility to smoking is defined as an absence of firm commitment not to smoke in the future or when offered a cigarette by best friends. Susceptibility begins in adolescence and is the first step in the transition to becoming an established smoker. Many scholars have hypothesized and studied whether psychosocial risk factors play a crucial role in preventing adolescent susceptibility to smoking or discourage susceptible adolescents from becoming established smokers. Our study examined sociodemographic and family and childhood environmental factors associated with smoking susceptibility among adolescents in a peri-urban area of Nepal.DesignWe conducted a population-based cross-sectional study during October–November 2011 in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) located in a peri-urban area near Kathmandu, the capital city of Nepal, where tobacco products are easily available. Trained local enumerators conducted face-to-face interviews with 352 respondents aged 14–16. We used stepwise logistic regression to assess sociodemographic and family and childhood environmental factors associated with smoking susceptibility.ResultsThe percentage of smoking susceptibility among respondents was 49.70% (95% CI: 44.49; 54.93). Multivariable analysis demonstrated that smoking susceptibility was associated with smoking by exposure of adolescents to pro-tobacco advertisements (AOR [adjusted odds ratio] =2.49; 95% CI: 1.46–4.24), the teacher (2.45; 1.28–4.68), adolescents attending concerts/picnics (2.14; 1.13–4.04), and smoking by other family members/relatives (1.76; 1.05–2.95).ConclusionsSmoking susceptible adolescents are prevalent in the JD-HDSS, a peri-urban community of Nepal. Several family and childhood environmental factors increased susceptibility to smoking among Nepalese non-smoking adolescents. Therefore, intervention efforts need to be focused on family and childhood environmental factors with emphasis on impact of role models smoking, refusal skills in social gatherings, and discussing harmful effects of smoking with family members and during gatherings with friends.

Highlights

Susceptibility to smoking is defined as an absence of firm commitment not to smoke in the future or when offered a cigarette by best friends
The present study examined the sociodemographic and family and childhood environmental factors associated with smoking susceptibility in 14Á16-year-old Nepalese adolescents
Parallel with different health behavior theories (8Á11), our study demonstrates that exposure to family and childhood environmental factors such as pro-tobacco advertisements and smoking by family members or teachers encourages adolescents to initiate smoking when they have easy access to cigarettes and opportunities to smoke in the absence of parents

Summary

Introduction

Susceptibility to smoking is defined as an absence of firm commitment not to smoke in the future or when offered a cigarette by best friends. Our study examined sociodemographic and family and childhood environmental factors associated with smoking susceptibility among adolescents in a peri-urban area of Nepal. Design: We conducted a population-based cross-sectional study during OctoberÁNovember 2011 in the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) located in a peri-urban area near Kathmandu, the capital city of Nepal, where tobacco products are available. We used stepwise logistic regression to assess sociodemographic and family and childhood environmental factors associated with smoking susceptibility. Conclusions: Smoking susceptible adolescents are prevalent in the JD-HDSS, a peri-urban community of Nepal. Several family and childhood environmental factors increased susceptibility to smoking among Nepalese nonsmoking adolescents. Intervention efforts need to be focused on family and childhood environmental factors with emphasis on impact of role models smoking, refusal skills in social gatherings, and discussing harmful effects of smoking with family members and during gatherings with friends

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