Incidence and predictor of tobacco experimentation among high-school adolescents of Sousse, Tunisia

Abstract

Abstract Background Tobacco use is considered one of the leading risk factors for early morbidity and mortality especially in developing countries. Initiation of tobacco use occurs usually during adolescence which is responsible for a longer time of exposure to nicotine and other constituents of tobacco products. The aim of this study is to determine the incidence and the factors associated with tobacco experimentation among high school students in the governorate of Sousse between 2017/2018 and 2018/2019. Methods A prospective longitudinal study was conducted in 4 high schools in the governorate of Sousse during the 2018-2019 school year. Pre-trained medical doctors ensured data collection using anonymous self-administered questionnaire. Collected data included socio-demographic and educational features, tobacco use, alcohol use, second hand smoking, illicit substances use, problematic internet use and mental health disorders. Results A total of 404 students were included in our study. The sex-ratio was 0.49 and the mean age of high school students was 16.4 (±1.1) years. At the end of the follow up, the incidence of tobacco experimentation among high school students was 9.7%. Problematic internet use was observed among the 36 (100%) adolescents who experimented tobacco while it was observed in 250 (79.9%) of who did not experiment tobacco during the follow up (p = 0.003). Otherwise, maternal tobacco use was the most influential factor on tobacco experimentation among participants with an odds ratio of: 7.1; 95% CI: 1.5-32.8) (p = 0,013). Conclusions Incidence of tobacco experimentation among the high school adolescents of Sousse is high. Second hand smoking and other addictive behaviors should be considered in order to reinforce the national prevention program of tobacco use. Key messages Reinforcement of the existing prevention program of tobacco use in Tunisia is required. Comprehensive prevention program of tobacco use taking into consideration the other addictive behaviors among adolescent and their entourage would be more effective.