Declining tobacco control awareness and support among Polish adolescents: Trends from the Global Youth Tobacco Survey 2003–2022

BackgroundTobacco smoking poses public health concerns because of its high risk for many chronic diseases. Most smokers begin using tobacco in their teens and recent reports indicate that smoking prevalence is climbing among youth. The Global Youth Tobacco Survey (GYTS) is a worldwide, school-based, tobacco-specific survey, but cross-cultural differences limit its effectiveness in international studies. Specifically, the GYTS assesses not only the prevalence of smoking, but also tobacco-related attitudes, school curricula, and advertisements, which are culturally influenced. Therefore, we conducted this study to develop a Chinese version of the GYTS for both national surveillance and international comparison.MethodsThe original English GYTS was translated and back translated using a cross-cultural adaptation process. The comprehensiveness and feasibility of using the Chinese-version GYTS were reviewed by a panel of 6 tobacco-control experts. The understandability and cultural relevance of the Chinese-version GYTS were discussed in a focus group of 5 schoolteachers and 8 students. The expert and focus group feedback was incorporated into a final Chinese version of the GYTS, which was administered to 382 students throughout Taiwan by multi-stage sampling from 10 randomly selected schools.ResultsThe internal consistency (Cronbach's alpha) for the GYTS subscales (smoking susceptibility, attitude toward smoking, and media messages about smoking) ranged from 0.70 to 0.94. The internal logical agreement of responses ranged from 85.3 to 99.2%.ConclusionThe Chinese version of the GYTS has good reliability and validity and can serve as the foundation for international comparison and tobacco control in Chinese-speaking communities.

Trend of Tobacco Use and Exposure to Secondhand Smoke Among Students Aged 13-15 Years in India and Selected Countries of the South-East Asia Region

Preventing tobacco use is a key aspect of health promotion during adolescence. We assessed prevalence and impact of school-based tobacco prevention programs in 43 countries. We performed a secondary analysis of national data of students aged 13-15 years (Global Youth Tobacco Surveys) from 43 countries during 2005-2011. National surveys of the corresponding school personnel (Global School Personnel Surveys) were performed in each country during the same year as the student surveys. Data on status of enforcement of national smoke-free school policies were obtained from the 2008 and 2009 WHO MPOWER reports. Logistic regression was used to measure ecologic-level associations between school-based tobacco prevention programs and tobacco-related knowledge and behaviour among students (P < 0.05). The proportion of students who were taught in class about the dangers of tobacco use during the school year ranged from 31.4% (Georgia) to 83.4% (Papua New Guinea). For every 10% increase (country level) in the proportion of teachers who reported having a tobacco prevention curriculum in their school, the odds of students reporting exposure to education in class about the dangers of tobacco increased by 6.0% (AOR = 1.06; 95% CI: 1.04-1.08). However, didactic education in class about the dangers of tobacco use was not independently associated with student current cigarette smoking behavior. Conversely, the likelihood of being a current smoker was significantly lower among students in countries with moderate/strongly enforced national smoke-free school policies compared with those in countries with poorly enforced/no national smoke-free school policies (AOR = 0.59; 95% CI: 0.45-0.76). Comprehensive tobacco prevention programs that include well-enforced smoke-free school policies may help reduce youth smoking.

Objective: This study was conducted to find out the youth perspective about the use of tobacco and its ill effects. The survey was conducted at a private Engineering college of Nagpur, Maharashtra India. Material and Methods: A cross-sectional study with self-administered modified Global youth tobacco survey (GYTS) questionnaire was used for data collection. Eight hundred nine college students of age group between 17 year-24years were included in this study. The questionnaire comprised of information on socio-demographic characteristics and questionnaire was used to gather data on knowledge, attitude and practices of participants about tobacco use. Data analysis was performed by using chi-square test and Statistical significance was measured at a level of 0.05. Result: Out of 806 total participants, 136 (16.8) were current tobacco consumers, significantly high prevalence of tobacco use was observed among boys 106 (13.1) than girls 30 (3.7). Moreover, a higher number of boys 106 (13.1) started smoking at young adolescent age (13- 20 years) than girls30 (3.7). Conclusion: The findings in the study suggest that tobacco use is still an important risk behavior amongst students. Tobacco use was comparatively higher amongst boys though its use is not restricted to them only. There is a need to plan to gather nationwide baseline data on the use of tobacco by young adolescents and the factors associated with initiation of tobacco habit.KeywordsGlobal youth tobacco survey (GYTS); Tobacco prevalence; Tobacco use among youth.

First tobacco-free generation in Europe - A lost cause? Latest Global Youth Tobacco Survey data from Poland and the CEE region.

The relationship between proximity of tobacco retail outlets to schools and tobacco use among school personnel in sub-Saharan Africa

Tobacco use is one of the major preventable causes of premature death and disease in the world. A disproportionate share of the global tobacco burden falls on developing countries, where an estimated 84% of the world's 1.3 billion current smokers live. The Global Youth Tobacco Survey (GYTS), part of the Global Tobacco Surveillance System (GTSS) initiated by the World Health Organization (WHO) and CDC, was developed to monitor youth tobacco use, attitudes about tobacco, and exposure to tobacco smoke, and has been completed by approximately 1.4 million students in 133 countries. A key goal of GTSS is for countries to conduct the GYTS every 4 years. This report presents findings from the GYTS conducted in the Philippines in 2000 and 2003, which revealed substantial declines in the proportions of students aged 13-15 years who currently smoked cigarettes, currently used other tobacco products, were likely to start smoking in the next year, or were exposed to secondhand smoke in public places. The findings also indicated an increase in the proportion of students who supported bans on smoking in public places, had learned about the dangers of tobacco use in school, and had seen antitobacco messages in media and advertising. Public health authorities in the Philippines should evaluate their current tobacco-control programs and enhance or expand them to further reduce youth smoking.

Adolescents are particularly vulnerable to tobacco initiation and escalation. Identifying factors associated with adolescent tobacco susceptibility and use can guide tobacco prevention efforts. Novel machine learning (ML) approaches efficiently identify interactive relations among factors of tobacco risks and identify high-risk subpopulations that may benefit from targeted prevention interventions. Nationally representative cross-sectional 2013–2017 Global Youth Tobacco Survey (GYTS) data from 97 countries (28 high-income and 69 low-and middle-income countries) from 342,481 adolescents aged 13–15 years (weighted N = 52,817,455) were analyzed using ML regression tree models, accounting for sampling weights. Predictors included demographics (sex, age), geography (region, country-income), and self-reported exposure to tobacco marketing, secondhand smoke, and tobacco control policies. 11.9% (95% CI 11.1%-12.6%) of tobacco-naïve adolescents were susceptible to tobacco use and 11.7% (11.0%-12.5%) of adolescents reported using any tobacco product (cigarettes, other smoked tobacco, smokeless tobacco) in the past 30 days. Regression tree models found that exposure or receptivity to tobacco industry promotions and secondhand smoke exposure predicted increased risks of susceptibility and use, while support for smoke-free air policies predicted decreased risks of tobacco susceptibility and use. Anti-tobacco school education and health warning messages on product packs predicted susceptibility or use, but their protective effects were not evident across all adolescent subgroups. Sex, region, and country-income moderated the effects of tobacco promotion and control factors on susceptibility or use, showing higher rates of susceptibility and use in males and high-income countries, Africa and the Americas (susceptibility), and Europe and Southeast Asia (use). Tobacco policy-related factors robustly predicted both tobacco susceptibility and use in global adolescents, and interacted with adolescent characteristics and other environments in complex ways that stratified adolescents based on their tobacco risk. These findings emphasize the importance of efficient ML modeling of interactions in tobacco risk prediction and suggest a role for targeted prevention strategies for high-risk adolescents.

Tobacco use is the leading preventable cause of death and disease in the world; yet little is known about the levels or patterns of youth tobacco use on a global basis. The purpose of this paper is to focus on change in youth tobacco use using data from 100 sites that have conducted repeat Global Youth Tobacco Surveys (GYTS). The GYTS is a school-based survey that collects data from students aged 13-15 years using a standardized methodology for constructing the sample frame, selecting schools and classes, and processing data. GYTS is conducted in school classes using self- administered anonymous data collection. The GYTS sample produces representative, independent, cross-sectional estimates for each sampling frame. Of the 100 sites surveyed, 61 reported no change over time in prevalence of cigarette smoking, likewise in 50 of the 97 sites with data on use of other tobacco products there was no change. However, 34 sites reported an increase in other tobacco use. This appears to be attributed to waterpipe, an emerging trend in tobacco use. Evidence was found supporting the idea that tobacco use among adolescent girls is likely increasing. The global tobacco control effort continues to face many challenges in reversing the tobacco epidemic. Few countries have implemented comprehensive tobacco control legislation laid out by the World Health Organization. The few countries that have adopted some of these proven policies can serve as exam- ples in achieving positive results in curbing the tobacco epidemic. (Global Health Promotion, 2009; Supp (2): pp. 38-90)

Objective: The Global Youth Tobacco Survey (GYTS) is a worldwide collaborative surveillance initiative that includes governments and non-governmental organisations under the leadership of the World Health Organization/Tobacco Free Initiative (WHO/TFI)...

The trajectory of adolescent tobacco use is the best predictor for the global lung cancer community to anticipate future smoking-related disease. Tobacco use viewed as risky behaviour tells us about future implications for the local adolescent population as it enters adulthood. Adolescent tobacco use as an indicator of local tobacco control tells us about the effects of local control measures, the impact for example, of the Framework Convention on Tobacco Control (FCTC) (1) and about potential vulnerabilities (such as to tobacco industry marketing) of the population in question. Worldwide, the level of adolescent tobacco use ranges from around 2% to over 30% depending on region and on the form of tobacco (cigarette or other), in data presented from the Global Youth Tobacco Survey on the Tobacco Atlas (2). Overall about a fifth of young teenagers (13–15 years) around the world are smokers (3). High-income countries (HICs) may have lower levels of adolescent tobacco use. In Australia for example, 2016 data from the National Drug Strategy Household Survey (4) show that smoking in teenagers aged 14–19 is at an all-time low of 3.0% down from 7.0% in 2013. Other countries with low rates include the United States (8% of high-school students) (5) and the UK (3% of 11–15-year-olds) (6). The Australian experience particularly reflects the value of policy innovation, plain tobacco packaging and sharp tobacco tax increases, on a background of comprehensive tobacco control policies over decades. This emphasises the importance of MPOWER measures (7) and adhering to the principles of the FCTC (1).

Tobacco uptake in adolescents is associated with a range of predictors. We examined the predictors of cigarette smoking, smokeless tobacco (ST) consumption, and use of both ST and cigarettes among adolescents in four South Asian countries. We analyzed the Global Youth Tobacco Surveys (GYTS) data for Bangladesh (2013), India (2009), Pakistan (2013), and Sri Lanka (2015), using multinomial regression to examine associations between several predictors and tobacco use. Data from 23 681 adolescents were analyzed. Overall, 82.8% of the study population were between 13 and 15 years and 52.7% were girls, 2% were cigarette smokers, 6.5% were ST users, and 1.1% used both ST and cigarettes, in the past 30 days. Exposure to smoking in public places was associated with past 30-day smoking (relative risk ratio [RRR] 5.59, 95% confidence intervals [CI] 4.28-7.28), ST use (RRR 2.07, 95% CI 1.84-2.32), and use of both ST and cigarettes (RRR 11.42, 95% CI 7.44-17.54). Exposure to tobacco use in electronic media and being offered free tobacco products were associated with all forms of tobacco use. Shopkeepers' refusal to sell cigarettes protected adolescents from smoking (RRR 0.47, 95% CI 0.36-0.63) and ST use (RRR 0.65, 95% CI 0.45-0.95). However, exposure to antitobacco mass media messages was not protective for any form of tobacco use. Adolescents taught at school about harmful effects of tobacco were less likely to use ST; no evidence of this association was observed for smoking. The associations between tobacco use and protobacco factors were strong, but the associations with antitobacco factors lacked strength and consistency in this study population. The predictors of adolescents using different tobacco products, crucial to inform and evaluate tobacco control efforts, are poorly understood. We investigated the associations between several environmental-level factors and cigarette smoking, ST consumption, and use of both forms among adolescents, whereas most of the previous studies focused on individual-level factors. Our study found strong associations between tobacco use and protobacco factors and lack of strength and consistency in associations between antitobacco factors and tobacco use in the study population. Our results indicate that the current tobacco control policies need strengthening to curb the tobacco epidemic in these countries.

Objectives: This study aimed to investigate tobacco use behaviours and their correlates among secondary school students in Nepal and Sri Lanka together with cross-country comparisons. Design: Cross-sectional survey. Methods and Settings: The data were obtained from the Global Youth Tobacco Survey (GYTS), 2007. Current tobacco use was considered as a response variable. Predictors were selected based on existing literature and theories on adolescent tobacco use. The data of 1,444 Nepalese and 1,377 Sri Lankan students aged 13–15 years was used for analysis. Results: Prevalence of tobacco use varies with 9.4% and 9.1% among Nepalese and Sri Lankan students respectively. Boys (13.2 vs. 5.3 for Nepal, 12.4 vs. 5.8 for Sri Lanka), older and senior students was more likely to be tobacco users in both countries. The average age of tobacco initiation was 10.2 years in Nepal and 8.6 years in Sri Lanka. Factors, namely, individual characteristics, tobacco use among friends, smoking at home and public places, free tobacco products, and lessons about negative effects of tobacco in class were significantly associated with tobacco use in Nepal and Sri Lanka. For instance, friends’ tobacco use was a good predictor for adolescents’ usage (odds ratio [OR] = 4.0, confidence interval [CI] = 2.61–6.23 in Nepal; OR = 2.5, CI = 1.50–4.23 in Sri-Lanka). Similarly, course curriculum significantly reduced smoking among students. Conclusion: Prevention of tobacco use among school students should be top priority of a country as they are long-term customers and replacement smokers who quit or die. Therefore comprehensive strategies as we proposed along with existing prevention programmes should be tightened to stop them from hazardous behaviours.

Background and Objectives: while existing research has demonstrated a positive association between exposure to point-of-sale (POS) tobacco advertising and youth smoking, there is limited evidence on the relationship between POS advertising restrictions and experimental smoking among youth. This study aims to fill this research gap by analyzing the association between POS advertising bans and youths' experimental smoking. Methods: Global Youth Tobacco Surveys from 130 countries during 2007–2011 were linked to the WHO “MPOWER” tobacco control policy measures to analyze the association between POS advertising bans (a dichotomous measure of the existence of such bans) and experimental smoking using weighted logistic regressions. All analyses were clustered at the country level and controlled for age, parents' smoking status, GDP per capita, and country-level tobacco control scores in monitoring tobacco use, protecting people from smoke, offering help to quit, warning about the dangers of tobacco, enforcing promotion/advertising bans, and raising taxes on tobacco. Results: The results suggest that a POS advertising ban is significantly associated with reduced experimental smoking among youth (OR = 0.63, p < 0.01), and that this association is seen for both genders (boys OR = 0.74, p < 0.1; girls OR = 0.52, p < 0.001). Conclusions: POS advertising bans are significantly associated with reduced experimental smoking among youth. Adopting POS advertising bans has the potential to reduce tobacco use among their youth in countries currently without such bans.

BackgroundTobacco use during adolescence is a substantial problem and adolescents are at higher risk of addiction and prolonged use. To reduce the burden of tobacco-related morbidity and mortality, monitoring of adolescent tobacco use is imperative. We aimed to determine the prevalence of tobacco use among adolescents in urban and rural secondary schools in Enugu State, southeast Nigeria.MethodsA cross-sectional study of 4332 adolescents in 8th to 10th grades in 25 urban and 24 rural secondary schools in Enugu, Nigeria was done using Global Youth Tobacco Survey (GYTS) methodology. Students were asked about previous and current tobacco use, smoking cessation, and susceptibility to smoking initiation among non-smokers. Geographical, age and sex prevalence differences were examined. Analyses were performed for all adolescents (10–19 years) and for a subset of students, 13–15 years of age for comparison with previous GYTS surveys. All analyses were weighted to account for the complex survey design and for differential non-response at school, class and student levels.ResultsAbout 28.9% of students reported ever smoking cigarettes; 19.4% reported current tobacco use among all adolescents (13.3, 5.8 and 7.8% for cigarettes, other smoked tobacco, and smokeless tobacco, respectively) while 18.6% reported current tobacco use among 13–15 year olds (12.6, 5.2 and 7.5% for cigarettes, other smoked tobacco and smokeless tobacco respectively). Prevalence of all types of tobacco use was higher in rural schools (vs. urban schools), and among boys (vs. girls). Susceptibility to smoking initiation among non-smokers was 9.3% (95% CI: 8.1–10.7) among all adolescents, and 9% (95% CI: 7.6–10.7) among 13–15 year olds. About 88.1% of all adolescent smokers desired to quit and 57.9% of them had never received help to quit smoking.ConclusionsNearly one in every five school-going adolescents currently uses at least one type of tobacco in Enugu State, southeast Nigeria. Prevalence of tobacco use is higher in rural schools and among boys in this setting. Most adolescent current smokers desire to quit and need smoking cessation support.