Global Youth Tobacco Survey Research Articles

Prevalence, Knowledge, Attitude, and Predictors of Waterpipe Smoking among School Adolescents in Saudi Arabia.

This cross-sectional study was designed to investigate the prevalence, knowledge, attitude, and predictors of waterpipe (WP) smoking among intermediate and secondary school adolescents in the Kingdom of Saudi Arabia (KSA). A self-administered anonymous questionnaire was used to collect data on demography, WP smoking status and patterns, the Arabic version of the Global Youth Tobacco Survey tool, and instruments to assess knowledge and attitude towards WP smoking. The Patient Health Questionnaire (PHQ-9) was also used. Descriptive and inferential statistical techniques were used. Modeling of WP smoking behavior was conducted using logistic regression. A total of 639 male students participated in this study. The prevalence of current WP and cigarette smokers were 17.7% and 14.6%, respectively. Out of the total population, 47.8% of students have the misconception that WP smoking is less harmful than cigarettes. A significant association (P < 0.05) of some demographic factors (age, school stage, residence, and parents' educational level) on WP smoking status was observed. Pleasure, socializing, and happiness represented the primary motives for initiating WP smoking. The majority of students had misconceptions about WP's health effects. More than 50% believed that smoking WP could ease anxiety, cause less harm, and has less addictive properties compared to cigarettes. Modeling suggested that the most significant predictors of WP smoking were cigarette smoking, depression, and the attitude index. Current findings warrant further research and official health programs to promote educational initiatives regarding WP smoking.

Sex and macroeconomic differences and trends in early attempts at cigarette smoking among adolescents: findings from 147 countries

BackgroundMost tobacco users initiate smoking during adolescence. Little is known about the global prevalence and trends in early cigarette smoking among adolescents. This study aimed to evaluate the prevalence of early attempts at cigarette smoking and its change trends among young adolescents.MethodsWe used data from the Global Youth Tobacco Surveys on adolescents aged 12–16 years, comprising 456,634 participants from 147 countries between 2006 and 2018, to estimate the prevalence of early attempts at cigarette smoking and age distribution at attempt by sex, country income, purchasing power parity (PPP) per capita, and WHO region. We assessed the average annual rate of reduction (AARR) in the prevalence of attempts at cigarette smoking before 12 years of age in 70 countries that had data from three or more surveys completed between 1999 and 2018.ResultsThe average prevalence of early attempts at cigarette smoking was 12.2% (95% CI: 10.9–13.5) for boys and 6.7% (95% CI: 5.8–7.6) for girls, with the highest prevalence of 17.4% for boys and 10.7% for girls in the European region. Along with the growth of the national economy, the prevalence of early attempts at cigarette smoking gradually increased in both sexes. A total of 22.9% and 30% of countries had a negative change in AARR for boys and for girls, respectively. The countries with an upward prevalence were mainly located in the Eastern Mediterranean, Southeast Asia, and African regions. The age distribution at first cigarette smoked did not differ substantially between sexes. Notably, the age at first cigarette smoked of 10.7 years for girls was significantly earlier than that of 11.8 years for boys in low-income countries. Among cigarette-smoking adolescents, the average percentage of girls reporting smoking their first cigarette at an age <12 years was 55.7% in Q1 for PPP quintiles, 46.5% in Q2, 40.3% in Q3, 38.4% in Q4, and 34.6% in Q5, and the corresponding prevalence for boys was 46.0% in Q1, 42.8% in Q2, 42.9% in Q3, 43.5% in Q4, and 41.1% in Q5.ConclusionsThe global prevalence of early attempts at cigarette smoking among adolescents was substantial, with differences by sex and macroeconomic situation, and our findings stress that interventions and policies targeting the first smoking experience are required to prevent the initiation of tobacco use among early adolescents, especially girls in low-income countries.

Association of Tobacco Advertising, Promotion, and Sponsorship (TAPS) exposure on smoking intention and current smoking behavior among youth in Indonesia

ABSTRACT Background This study aimed to assess the association of Tobacco Advertising Promotion and Sponsorship (TAPS) exposure on smoking intensity and smoking behavior among youth in Indonesia. Method This study used secondary data from the Global Youth Tobacco Survey (GYTS) 2019. The participants were secondary students from grades 7 to 12. We used multiple logistic regression to assess the association of TAPS exposure with smoking intention among smokers and current smoking status. Results More than half of participants (64,54%) reported being exposed by TAPS in television, followed by outdoor media (60,82%) and point of sales (55,45%). About 2.27% of 7,679 nonsmoking participants had the intention to smoke cigarettes. Furthermore, TAPS exposure in sports events, music concerts, community gatherings, or social events, being offered free tobacco products, owning the tobacco industry’s merchandise, and receiving vouchers of cigarettes discounts was associated with the smoking intention of nonsmokers and current smoking status. In addition, a significant association was found between TAPS exposure in television, the internet, and print media with current smoking status among youth in Indonesia. Conclusions TAPS exposure was significantly associated with smoking intention and smoking behavior among youth in Indonesia. Therefore, we recommended that the government ban TAPS in any form.

Secondhand smoke exposure among never-smoking adolescents in Wuhan, China

Without smoke-free legislation in Wuhan, China, we investigated secondhand smoke (SHS) exposure at home, school, and public places for never-smoking school-going adolescents in 2019. A cross-sectional study was carried out within the Global Youth Tobacco Survey (GYTS) framework. Weighted univariate, bivariate and multivariable analyses were conducted. The prevalence of SHS exposure among never-smoking adolescents at home, school and public places was 25.7%, 31.9% and 48.9%, respectively. Multivariable logistic regression analysis showed that parents smoking, peers smoking and observing teachers smoking in school were all significantly related to a higher probability of SHS exposure at home, school, and public places. Never-smoking adolescents who had smoking parents had 14 times (adjusted odds ratio [aOR], 14.00; 95% confidence interval [CI], 11.37–17.24) higher odds of SHS exposure at home; Never-smoking adolescents who observed teachers smoking in school had about 10 (aOR = 9.76; 95% CI = 7.13–13.36) and four times (aOR = 3.55; 95% CI = 2.77–4.55) higher odds of SHS exposure in school and public places, respectively. Adopting comprehensive smoke-free legislation in public places and smoke-free home rules and implementing and supervising smoke-free school policies may further reduce SHS exposure among adolescents.

Determinants of Adolescents' Desire to Quit Smoking in Indonesia: Data Analysis of the 2014 Global Youth Tobacco Survey

Background: The high prevalence of smoking is not only among adults but also among children and adolescents. Almost all adolescent smokers wish to quit smoking. They are aware of the dangers of cigarettes, tobacco, and other types so they are motivated to quit smoking. This study aims to determine the determinants of the desire to quit smoking in Indonesian students, using a cross-sectional study design. Method: This study is a secondary data analysis of the Global Youth Tobacco Survey (GYTS) in Indonesia in 2014. The sample of the study was all students in grades 7-9 in Indonesia who participated in the 2014 GYTS and had complete data, namely 5,986 people. Logistic regression statistical test analysis was used to determine the relationship between the determinants and the desire to stop smoking in adolescents. Results: Adolescents who want to quit smoking are 92.1%. There is a relationship between adolescents who have tried cigarettes and other types of tobacco on the desire to stop smoking behavior (OR=11,3; 95% CI=5,216-24,615; p&lt;0.025). There is a relationship between the dangers of smoking from family discussions on the behavior and desire of adolescents to stop smoking (OR=2,1; 95% CI=1,213-3,784; p&lt;0.025). Conclusion: Family support and motivation can assist adolescents in reducing smoking habits by monitoring and reminding adolescents of the purpose of quitting smoking, and by inviting adolescents to consult and take therapy with Public Health Services.

Prevalence and trends of active and passive smoking among Peruvian adolescents.

This study aimed to assess the trends of different smoking indicators among Peruvian adolescents. Additionally, we evaluated whether such trends were different by sex or among those without previous smoking history. We analyzed the Global Youth Tobacco Survey (Global Youth Tobacco Survey 2007, 2014, 2019). Active smoking was defined according to smoking in the last 30 days. Passive smoking was assessed based on exposure to tobacco inside and outside the household, both overall and daily. Analyses considered the sample design. A total of 17,047 records (9,869 in 2007, 3,424 in 2014, and 3,754 in 2019) were analyzed; the mean age was 14 years, and 49.9% were women. Previous smoking history was reported in 26.6% of the records; such prevalence fell from 45.2% (2007), to 25.3% (2014), and to 19.4% (2019, p-value for trend < 0.001), whereas active smoking fell from 17.1% (2007) to 8.7% (2014) and to 5.7% (2019). The overall prevalence of passive smoking inside the household fell from 24.7% to 12.9% and 10.4% (p-value <0.001), whereas the overall prevalence of passive smoking outside the household dropped from 46.3% to 39.4% and 36.3% (p-value <0.001) during the same period. The reduction of the smoking indicators was observed mainly among women than in men. There is evidence of a sustained reduction in smoking indicators in Peruvian adolescents. Passive smoking outside the household continues to be common, calling for strengthening current tobacco control policies.

Does tobacco use among adolescents come out of style in Czechia and Slovakia? Findings from the Global Youth Tobacco Survey between 2002 and 2016.

The aim of this study is to analyse Global Youth Tobacco Survey (GYTS) data on a prevalence of tobacco use, indicators of tobacco control and pro-tobacco activities in Czechia and Slovakia between 2002 and 2016. GYTS is a school-based survey of students aged 13-15 years carried out in Czechia and Slovakia in 2002/2003, 2007, 2011 and 2016. Standardized uniform questionnaires provided representative data. Between 2002 and 2016 the current cigarette smoking declined both in Czechia and Slovakia (from 34.6% and 26.4% to 15.2% and 17.1%, respectively). Indicators of tobacco control activities either did not change (access to buy cigarettes by minors) or decreased (school-based and mass media interventions). Indicators of pro-tobacco activities declined (being ever offered by a free tobacco product and having something with a tobacco product brand logo on it). Tobacco use is on decline and the situation becomes similar to the most of European countries. Preventive activities are only partially responsible for the process. Rather effect of global trends accelerated by widespread use of social media can play a role.

Prevention of initiation of smokeless tobacco (SLT) consumption among rural children

Background: India Global Youth Tobacco Survey 2019 observed that 8.5% of the young age group (13-15 years) consume tobacco (9.6 % are boys and 7.4 % are girls). No interventional studies among adolescents were conducted before the initiation of the SLT use. Aims &amp; Objectives: To estimate the prevalence of consumption of tobacco and non-tobacco products and to provide school based interventions to bring behavioral changes. Materials and Methods: An interventional study was carried out in Primary Schools. For estimation of the prevalence of tobacco and non tobacco use all the students of 1st to 5th while for the interventions, 4th and 5th standard were selected. Baseline data and change in the behavior at the end of one year was collected. FGD with key informants were also conducted. Descriptive Statistics was conducted. Results: The prevalence of smokeless tobacco consumption and non-tobacco product was found to be 1.3% and 36.5% respectively. After intervention 40.5% students had quit non tobacco products. Findings of FGD suggested that children should not be sent to purchase tobacco products on behalf of their parents. Conclusion: School based intervention and sensitization of the field workers along with knowing their perceptions for the predictors of consumption could be useful.

Use of e-cigarettes and associated factors among adolescent smokers in Indonesia: Analysis of the Global Youth Tobacco Survey (GYTS) Indonesia 2019

Background: Electronic cigarette (e-cigarette) is an alternative to reduce the harmfulness of conventional cigarettes. However, there are still pros and cons to using the e-cigarette, especially among adolescents. Instead of reducing the health problem, using e-cigarette even make the illness the same as conventional ones. Objective: This study aimed to examine the determinant of using e-cigarettes among adolescents and smokers of school age. Method: This study used the cross-sectional data from the Global Youth Tobacco Survey (GYTS) Indonesia 2019. The national school was selected by proportional random sampling. Around 832 adolescent smokers were eligible for this study. Results: Among 832 adolescent smokers in this study, about 49.64% of them ever used e-cigarettes. The factors significantly associated with the use of e-cigarettes were money pocket and the use of other forms of smoked tobacco. However, other independent variables, such as age, gender, teachers smoking during school hours, and parent smoking, were not significantly associated with using e-cigarettes. Conclusion: The factors associated with e-cigarette use were related to the students’ socioeconomic status. The roles of parents and teachers need to be addressed to reduce the harmfulness of using e-cigarettes.

Adolescent Smoking: A Cross-sectional Study on the Knowledge, Attitude and Practices of Filipino Adolescents in a Tertiary Hospital

Objective. The study aims to determine the knowledge, attitudes and practices of Filipino adolescents aged 13-18 years old regarding cigarette smoking.&#x0D; Methods. This is a descriptive cross-sectional study that utilized a questionnaire adapted from the Global Youth Tobacco Survey.&#x0D; Results. The prevalence among study participants who tried smoking (11.8%) and current users (3.6%) is lower than the global statistics and the country’s reported prevalence, but started at a younger age (5.3% started smoking at 12-13 years old). Electronic cigarette (12.9%) is more commonly tried and used than conventional cigarettes (11.8%). Ninety five percent (95%) of the participants view smoking as harmful. Some (13.5%) do not know the effects of smoking, 1.1% consider it harmless, and 8.2% have no objections to starting to smoke someday. Most adolescents (49.1%) do not know the price of cigarettes, but 22% prefer to pay less than the actual price.&#x0D; Conclusion. Adolescents are knowledgeable and have a negative attitude towards smoking. Regardless if they are non-smokers, tried smoking, or are currently smoking, they still need to be educated more regarding the effects and consequences of smoking.

Association between the implementation of tobacco control policies and adolescent vaping in 44 lower-middle, upper-middle, and high-income countries.

To (i) estimate the prevalence of adolescent vaping in 47 lower-middle, upper-middle and high-income countries, and (ii) test the association between implementation of World Health Organisation (WHO) tobacco control policies and adolescent e-cigarette use (also known as vaping) in 44 countries where implementation data were available. Cross-sectional surveys. A total of 47 lower-middle, upper-middle and high-income countries. A total of 151 960 adolescents (typically ages 13-15) who participated in WHO's Global Youth Tobacco Survey between 2015 and 2018. Prevalence of past-30-day vaping and past 30-day frequent vaping (≥10 days) were estimated from the surveys. Data on the implementation of six tobacco control measures including monitoring, smoke-free policies, cessation programs, warning about the dangers of tobacco, advertising bans and taxation were taken from WHO's report on global tobacco epidemic. The overall weighted prevalence of adolescent vaping and frequent vaping in the past 30 days was 8.6% (95% CI, 8.3-8.9) and 1.7% (95% CI, 1.6-1.8), respectively. For five of WHO's policies (monitoring, smoking-free environment, cessation programs, health warning and advertising bans), their association with adolescent vaping was inconclusive because of large variation of their effects across countries. Higher tax on combustible tobacco products was associated with higher adolescent vaping (> = 75% tax vs < 25% tax; odds ratio = 2.58; 95% CI, 1.25-5.21). In 47 lower-middle, upper-middle and high-income countries from 2015 to 2018, ~1 in 12 (8.6%) adolescents reported vaping in the past 30 days, but prevalence of frequent vaping was low (1 in 60; 1.7%). A higher tobacco tax was associated with higher adolescent vaping.

School tobacco-related curriculum and behavioral factors associated with cigarette smoking among school-going adolescents in Zambia: Results from the 2011 GYTS study.

INTRODUCTIONTobacco smoking is a global public health concern. It has been projected that children and young people who are alive today in developing countries will bear the most burden of tobacco-related morbidity and mortality in the near future. This study investigated the school tobacco-related curriculum and behavioral factors associated with cigarette smoking among school-going adolescents.METHODSWe accessed secondary data in a public domain collected using a cross-sectional study design. Altogether, 3377 seventh to ninth grade students were selected by stratified two-stage cluster sampling. Data were collected using a Global Youth Tobacco Survey (GYTS) Core Questionnaire. Multivariate logistic regression models were used to determine associations of school tobacco-related curriculum and behavioral factors with current cigarette smoking status. Adjusted odds ratios and their 95% confidence intervals are reported.RESULTSOf the 2611students included in the analysis, 6.8% (7.8% of males and 5.8% of females) reported smoking cigarettes. Slightly over half of the students were taught in schools about the effects of smoking (53.6%) and the dangers of smoking (64.1%). Adolescents who had friends who smoked were more likely to smoke compared to those who did not have friends who smoked. Adolescents whose parents smoked were more likely to smoke compared to those who did not have parents who smoked. Adolescents who were not taught at school about the dangers of smoking, or were not sure about it, were more likely to smoke compared to those who were taught (AOR=1.94; 95% CI: 1.28–2.94).CONCLUSIONSSchools play an important role in shaping smoking behavior among school-going adolescents. Based on our findings, school programs aimed at reducing cigarette smoking among school-going adolescents may achieve greater impact by implementing anti-smoking interventions that involve parents and peers in smoking prevention activities, and have a robust tobacco school curriculum.

Prevalence and correlates of current tobacco use and non-user susceptibility to using tobacco products among school-going adolescents in 22 African countries: a secondary analysis of the 2013-2018 global youth tobacco surveys

BackgroundOur study examined the prevalence and associated factors of tobacco product use and non-users’ susceptibility to using tobacco products among school-going adolescents in 22 African countries.MethodsWe analyzed the cross-sectional 2013-2018 Global Youth Tobacco Survey (GYTS) data from 22 African countries. We conducted complex sampling descriptive and logistic regression analyses.ResultsThe overall prevalence of current use of any tobacco product among adolescents was 19.1%, with more males (23.7%) than females (13.7%) being current users. Zimbabwe and Morocco were the highest (47.1%) and least (12.6%) reported prevalence, respectively. Being male (AOR = 1.93;95%CI:1.61-2.32), being 16 and older(AOR = 1.37;95%CI:1.01-1.86), exposure to secondhand smoke within (AOR = 1.98;95%CI:1.69-2.32) and outside (AOR = 1.37;95%CI:1.13-1.65) the home, not knowledgeable about the harmful effect of secondhand smoke (AOR = 1.44;95%CI:1.20-1.74), exposure to tobacco industry promotion (AOR = 3.05;95%CI:2.68-3.47) and not in favour of banning smoking in enclosed places (AOR = 1.32;95%CI:1.08-1.60) were associated with current use of any tobacco product.The prevalence of the susceptibility to using tobacco products among never users of tobacco products was 12.2%, with no significant gender difference. Mozambique (24.6%) and Algeria (4.5%) had the highest and least prevalence of susceptibility to using tobacco products among never users, respectively. Exposure to tobacco industry promotion (AOR = 1.54;95%CI:1.31-1.82), those not in favour of banning smoking in enclosed places (AOR = 1.29;95%CI:1.14-1.45) and those not exposed to anti-smoking school education (AOR = 1.24;95%CI:1.06-1.46) were associated with susceptibility to using any tobacco product among never users of tobacco products.ConclusionOur study reports that tobacco use and non-user susceptibility to using tobacco products among school-going adolescents in the 22 African countries is high. As part of public health efforts, governments and other stakeholders need to fully implement anti-tobacco use campaigns, enforce a complete ban on tobacco promotion and advertising, institute educational programs for families, and anti-tobacco use education for the general public and in schools in line with WHO Framework Convention on Tobacco Control guidelines.

Prevalence of E-Cigarette Use and Its Associated Factors Among Youths Aged 12 to 16 Years in 68 Countries and Territories: Global Youth Tobacco Survey, 2012‒2019.

Objectives. To describe the recent global prevalence of e-cigarette use and to investigate its associated factors among youths aged 12 to 16 years in 68 countries and territories (hereafter "countries"). Methods. We analyzed 485 746 youths aged 12 to 16 years from the population-based cross-sectional Global Youth Tobacco Survey conducted in 67 countries between 2012 and 2019 and the 2019 National Youth Tobacco Survey in the United States. We defined past-30-day e-cigarette use as using e-cigarettes on 1 or more days during the past 30 days. Results. The global prevalence of past-30-day e-cigarette use among youths was 9.2%, ranging from 1.9% in Kazakhstan to 33.2% in Guam. Maternal smoking (adjusted odds ratio [AOR] = 1.40; 95% confidence interval [CI] = 1.29, 1.52), paternal smoking (AOR = 1.13; 95% CI = 1.07, 1.19), secondhand smoke exposure (AOR = 1.74; 95% CI = 1.64, 1.84), youth cigarette smoking (AOR = 7.18; 95% CI = 6.84, 7.54), and youth other tobacco use (AOR = 3.88; 95% CI = 3.62, 4.15) were positively associated with e-cigarette use. Conclusions. E-cigarette use was moderately frequent among youths aged 12 to 16 years globally. Several important factors were associated with youth e-cigarette use. Public Health Implications. Our findings highlight the need for countries worldwide to develop policies to address e-cigarette use among youths. (Am J Public Health. 2022;112(4):650-661. https://doi.org/10.2105/AJPH.2021.306686).

Prevalence of Cigarette Smoking and Influence of Associated Factors among Students of the University of Banja Luka: A Cross-Sectional Study.

Background and Objectives: Cigarette smoking among the youth population has increased significantly in developing countries, including Bosnia and Herzegovina. However, no extant literature assesses the prevalence of tobacco use, nor identifies factors associated with smoking. This study determined the prevalence of cigarette smoking among a specific cohort of students and assessed factors related to tobacco use in this population. Materials and Methods: This cross-sectional study included 1200 students at all faculties of Banja Luka University. Data were collected from questionnaires adapted from the Global Youth Tobacco Survey (GYTS) and the Global Health Professional Student Survey (GHPSS) standardized questionnaires and were analyzed using descriptive statistics, Pearson’s χ2 test, and logistic regression. Results: When the prevalence of cigarette smoking within the last thirty days was recorded, we found that 34.1% of students smoked within this period. Nearly three-quarters (74.9%) of the student population had smoked or experimented with cigarette smoking. However, medical students were 27.2% less likely to smoke than their counterparts from other faculties. Overall, 87% of all students were aware of the harmful effects of cigarette smoking, 79% were aware of the harmful effects of secondhand smoke, and 65% reported that it was difficult to quit. Increased spending of personal money was associated with a higher probability of smoking, while exposure to secondhand smoke increased the odds of smoking by 62%. Conclusion: Policies, strategies, and action plans should be introduced in order to reduce the prevalence of smoking among university students and to create a smoke-free environment at the various universities involved.

Prevalence and associated factors of Smokeless Tobacco (SLT) use among adolescents in Indonesia: GYTS 2019 data analysis

Background: Smokeless tobacco (SLT) use is a new trend since the banning of smoking in many public places, including among adolescents. Many people believe that SLT is a harmful reduction method compared to cigarettes. However, there are many risks of using the SLT, such as Head and neck cancer (HNC), cancer of the mouth, and coronary heart disease. Objective: This study aimed to examine the prevalence and the factors associated with SLT use among adolescents in Indonesia. Methods: This study used the cross-sectional data from the Global Youth Tobacco Survey (GYTS) Indonesia 2019. The national school was selected by proportional random sampling. Around 8,828 students were eligible for this study. Results: This study found the prevalence of SLT use was 3.25%. The bivariate test found each independent variable was significantly associated with the SLT use. However, the adjusted test found that age, smoking parent, smoking teacher, knowledge, and attitude were significantly associated with SLT use. Conclusion: The variables mostly related to SLT use come from the family and school environment. The appropriate intervention needs to be arranged to reduce the prevalence of smokers, including SLT use.

Influence of Personal, Environmental, and Community Factors on Cigarette Smoking in Adolescents: A Population-Based Study from Taiwan.

Understanding the factors that influence cigarette smoking among adolescents is critical. We identified personal, community, and environmental factors associated with current cigarette smoking among adolescents. This population-based cross-sectional analysis study was conducted using the 2012 Taiwan Global Youth Tobacco Survey and the sociodemographic statistics of the city or county from Taiwan’s Ministry of the Interior. A total of 27,524 participants (age: 12–18-years) was included. The associated factors were identified through logistic regression. A path analysis was performed to examine the pathway from the associated factors to current cigarette smoking. According to this analysis, the following factors were prominently and positively associated with adolescent cigarette smoking: one personal factor (pocket money), five environmental factors (home secondhand smoke (SHS) exposure, smoker friends, outside SHS exposure, school SHS exposure, and smoker parents), and two community factors (free cigarettes from tobacco companies and indigenous population). By contrast, five personal factors (feeling less comfortable smoking at social occasions, feeling indifferent about smoking or not smoking at social occasions, female sex, feeling that quitting is difficult, and feeling that quitting after having smoked is harmful to health) and one environmental factor (school antismoking education) had negative effects. Thus, comprehensive interventions promoting the perception of harm caused by smoking and interrupting access to cigarettes through social networks can reduce cigarette smoking in adolescents.

Tobacco Use among School-Going Adolescents in Comoros: A Secondary Analysis of the 2015 Comoros Global Youth Tobacco Survey.

Background Tobacco use among adolescents has long-term adverse health consequences, especially during adulthood. Currently, little is known about tobacco use behaviour among adolescents in Comoros. Our study aims at estimating the prevalence and identifying key factors associated with tobacco use among adolescents in Comoros using the 2015 Comoros Global Youth Tobacco Survey data. Methods A national cross-sectional survey secondary data of 2,810 eligible school-going adolescents aged between 11 and 17 years was analysed. Complex sample logistic regression analyses were used to determine the correlates of current cigarette smoking and current use of noncigarette tobacco products. Results The overall prevalence of current cigarette smoking was 14.3% [males (18.5%) and females (9.9%)]. The prevalence of current use of noncigarette tobacco products was 5.8% [males (6.7%) and females (4.9%)]. Being male (AOR = 2.24; 95% CI:1.39-3.63), exposure to secondhand smoke inside (AOR =3.88; 95% CI:2.84-5.31) and outside (AOR =1.49; 95% CI: 1.08-2.03) their home, and exposure to tobacco industry promotion (AOR =2.90; 95% CI:2.21-3.80) were associated with current cigarette use among school-going adolescents. However, parental smoke (AOR = 1.20; 95% CI:0.78-1.87) and not exposed to antismoking education in schools (AOR = 0.97; 95% CI:0.76-1.22) were not associated with current cigarette use. On the other hand, being male (AOR = 1.24; 95% CI:0.82-1.86) was not associated with the current use of noncigarette tobacco products. Adolescents who were exposed to tobacco industry promotion (AOR = .2.58; 95% CI:1.54-4.32) and not exposed to antismoking education in school (AOR = 0.52; 95% CI:0.32-0.85) were more and less likely associated with noncigarette tobacco use. Conclusion One in seven school-going adolescents smokes cigarettes, and approximately one in 20 school-going adolescents uses noncigarette tobacco products in Comoros. Exposure to secondhand smoke within and outside the home and exposure to tobacco industry promotion were associated with tobacco use in school-going adolescents in Comoros. Our findings suggest the need for adolescent-friendly gender-sensitive tobacco interventions, including strengthening existing tobacco control laws to prevent and reduce tobacco use among school-going adolescents in Comoros.

Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control (FCTC): The case for Tunisia.

INTRODUCTIONThe World Health Organization (WHO) had launched the Framework convention on Tobacco Control (FCTC) in 2003 in order to curve the epidemic of tobacco use worldwide. Since most smokers begin to smoke before the age of 18 years, Global Youth Tobacco Survey (GYTS) has been developed in order to monitor tobacco smoking among adolescents. Our aim was to assess smoking among Tunisian youth using GYTS 2017 data.METHODSGYTS is cross-sectional, two cluster school-based survey to produce a representative sample of students aged 13–15 years. It was conducted in 2017 in 67 secondary schools in Tunisia. The investigation tool was an anonymously answered questionnaire, which contained core questions about six majors tobacco related topics.RESULTSLifetime cigarettes and waterpipe prevalence were 7.8% (14.4% of boys, 1.6% of girls, p<0.001) and 7.2% (13% of boys, 2.8% of girls, p<0.001), respectively. Among cigarette smokers, 62.5% were able to buy their own cigarettes. Overall, 23.5% of cigarette smokers and 41.5% of waterpipe smokers were not able to buy their products because of their age. Sixty percent of smokers wanted to quit and 56.4% had already tried to stop. Half of the respondents were exposed to SHS in their homes and 62.1% in indoor public places.CONCLUSIONSIn Tunisia, tobacco prevalence among youth is high. Youth have free access to tobacco products and smoke-free regulations are only partially respected.

Youth susceptibility to tobacco use in the Gulf Cooperation Council Countries, 2001–2018

The Gulf Cooperation Council (GCC) countries – Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE) – ratified the Framework Convention on Tobacco Control (FCTC) in 2006. Yet, GCC countries predict a slight reduction in tobacco use compared to the Eastern Mediterranean region’s significant downward trend. The purpose of this study was to examine changes in self-reported intention to initiating tobacco use (susceptibility) among youth over time in five GCC countries and the relationship between susceptibility and key FCTC provisions. Complex sample logistic regression analyses were conducted using data from the 2001 to 2018 Global Youth Tobacco Survey (n = 349,878 adolescents). Since the ratification of FCTC in GCC countries, susceptibility to initiate tobacco use significantly decreased in Bahrain and Qatar while it increased in UAE (P < 0.001). Exposure to smoking in public places increased the odds of susceptibility to tobacco use in Bahrain (AOR = 1.6, 95% CI = [1.2–2.2), Kuwait (AOR = 1.6, 95% CI = [1.2–2.0]), Qatar (AOR = 1.9, 95% CI = [1.4–2.6]), and UAE (AOR = 2.1, 95% CI = [1.6–2.7]). Susceptibility to tobacco use was significantly associated with exposure to tobacco imagery in media in the UAE (AOR = 1.7, 95% CI = [1.2–2.3]) and with tobacco industry activities like promotion in Bahrain (AOR = 2.8, 95% CI = [1.9–4.2]) and Kuwait (AOR = 2.2, 95% CI = [1.5–3.1]). In conclusion, the impact of FCTC provisions on tobacco use differs across countries. Findings suggested that the implementation of tobacco control policies may independently influence the initiation of tobacco use.