Tobacco use in school students in Afghanistan, Oman and Kuwait and association with parental monitoring: analysis of data from Global School-based Student Health surveys.

Abstract

Nationally representative data are lacking on cigarette smoking in adolescents in Afghanistan, Oman and Kuwait, which are considered low-income, middle-income and high-income countries respectively of the World Health Organization Eastern Mediterranean Region. This study examined the effect of parental monitoring on the tobacco use of adolescent school students in Afghanistan, Oman and Kuwait. Using data from the 2014 Afghanistan, 2015 Oman and 2015 Kuwait Global School-based Student Health surveys, factors associated with cigarette smoking and tobacco use among the students in the 30 days before the survey were analysed. These factors included: parental understanding of their problems/worries, parental awareness of how they spent their free time, parents searching their belongings without their approval, and parents checking if homework was done. Logistic regression analysis was used to determine the association between tobacco use and parental monitoring. The prevalence of cigarette smoking and/or use of other tobacco products by the students on one or more days in the 30 days before the survey was 10.6% in Afghanistan, 9.3% in Oman and 28.8% in Kuwait. Adolescents whose parents understood their problems, were aware of how they spent their free time, and checked if their homework was done were less likely to be current tobacco users in all three countries (P < 0.05). Adolescents in Oman and Kuwait whose parents searched their belongings were more likely to use tobacco (P < 0.01). The prevalence of tobacco use in the adolescents, especially in Kuwait, suggests the need for better schoolbased health education and promotion programmes in these countries.