Predictors Of Tobacco Use Research Articles

Prevalence, patterns and contributing factors for tobacco usage amongst Saudi population - analysis from SHIS 2013.

The present study aimed to determine the prevalence, patterns and contributing factors for tobacco usage amongst Saudi population. Between April and June 2013, a cross-sectional study was organized among 10735 individuals aged 15 years or older. The survey consisted of face-face interview for collecting data on socio-demographics, tobacco usage, diet, physical activity and comorbidities. Univariate and multivariate binary logistic regression was applied to check for the association of prevalence (both smoked and smokeless) with socio-demographic factors. The strength of association was examined by approximating odds ratios (OR) with their 95% CI using SPSS software and p-value set at < 0.05. A total of 10195 respondents aged from 15 to 101 were considered. Overall prevalence of current smoking was 12.8%. Daily smoking was reported by 12% of the population. Sex, age group, education, married and occupation were strong predictors of tobacco use in both univariate and multivariable model. From multivariable model, men were 14.54 times more likely to smoke tobacco (aOR 14.54, 95% CI 11.07-19.11) when compared with women. Respondents between 15 to 30 years, 31 to 45 years, were 3.36 times (aOR 3.36, 95% CI 2.29-4.93) and 3.51 times (aOR 3.51, 95% CI 2.47-4.98) more likely to smoke tobacco when compared to >60 years. The results of present study indicate a significant, but differing purpose of sex, age group, education, marital status and work status on tobacco usage in the country.

Predicting Tobacco Use Based on the Theory of Planned Behavior in Adolescent Girls

Introduction: Tobacco use poses a serious threat to global health. The tobacco epidemic is spreading in low- and middle-income countries, where the tobacco industries mainly target young people and women. Objective: This study aims to determine the predictors of tobacco use based on the theory of planned behavior (TPB) in female high school students. Materials and Methods: This cross-sectional study was conducted on 340 female high school students aged 14-18 years in Rasht City, Iran, who were selected using a multi-stage sampling method. The data collection tool was the TPB questionnaire for tobacco use in Persian. The obtained data were analyzed using the Mann-Whitney U test, Kolmogorov-Smirnov test, Spearman correlation test and logistic regression analysis. Results: The TPB constructs of attitude (OR = 0.91, 95% CI: 0.85-0.97, P = 0.007) and behavioral intention (OR=0.75, 95% CI; 0.64-0.88, P = 0.001) could predict cigarette smoking. Also, constructs of perceived behavioral control (OR = 0.92, 95%CI; 0.87-0.97, P = 0.007), subjective norms (OR = 0.83, 95%CI; 0.70-0.97, P = 0.02), and behavioral intention (OR = 0.88, 95% CI; 0.78 - 0.99, P = 0.03) could predict hookah smoking in girls students. Conclusion: Considering the predictive power of the TPB constructs in tobacco use by adolescent girls, it is possible to plan to reduce its rate in this group by a focus on the TPB constructs.

LGB Tobacco Control: Do Health Belief Model Constructs Predict Tobacco Use Intentions Differently between LGB and Heterosexual Individuals?

This research includes two studies testing whether the Health Belief Model (HBM) constructs predict tobacco use intentions differently between heterosexual and lesbian, gay, and bisexual (LGB) people. Focusing on cigarette smoking, Study 1 (n = 1808 U.S. adult current smokers) found that the perceived health threat and perceived benefits of smoking differently predicted intentions to continue smoking between heterosexual and LGB smokers. The perceived health threat of smoking had a weaker negative relationship and perceived benefits of smoking had a stronger positive relationship with smoking intentions among LGB smokers than heterosexual smokers. Focusing on vaping, Study 2 (n = 2801 U.S. adults) found that the perceived health threat and perceived barriers of vaping differentially predicted vaping intentions between heterosexual and LGB individuals. The perceived health threat of vaping only negatively predicted vaping intentions among heterosexual people. Perceived barriers to vaping had a stronger negative relationship with intentions to vape among LGB people than among heterosexual people. Our finding suggests that compared to perceptions of tobacco-related health consequences (perceived heath threat), behavioral perceptions (perceived benefits and barriers) may have stronger impacts on tobacco use intentions among LGB people. Thus, efforts focusing on reducing tobacco-related disparities among the LGB community should address perceived benefits and barriers of tobacco use.

Prevalence and predictors of tobacco use among currently married pregnant women in India

Prevalence and predictors of tobacco use among currently married pregnant women in India

Understanding Adverse Childhood Experiences as Predictors of Cigarette and E-Cigarette Use

Adverse childhood experiences contribute to both short- and long-term health issues and negative health behaviors that affect the individual as well as families and communities. Exposure to ≥4 of the 11 adverse childhood experiences (high adverse childhood experiences) compounds the problems in later life. This study assesses the associations among tobacco use, adverse childhood experiences, mental health, and community health. This study was a secondary data analysis utilizing a large 2019 data set from a Community Health Needs Assessment in Florida (N=14,056). Investigators utilized inferential statistics to determine adverse childhood experiences as a predictor of tobacco use (vaping and cigarette use). In addition, they examined whether a shorter, 2-question adverse childhood experience scale was equivalent to the full scale when predicting tobacco use. The results indicated that parental divorce was the most common household stressor, followed by mental illness and alcoholism. High adverse childhood experiences were found to be most prominent in marginalized individuals. For those individuals experiencing ≥4 adverse childhood experiences, parental divorce continued to rank high, followed by mental illness. Household stressors included emotional and physical abuse as the most prevalent in the ≥4 adverse childhood experience group. High adverse childhood experiences were associated with current cigarette smoking (AOR=1.56) after controlling for individual mental health and social/community health variables. High adverse childhood experiences were also associated with E-cigarette use (AOR=1.81) but not dual cigarette/E-cigarette use. Social and community health was inversely associated with tobacco use. A 2-item adverse childhood experiences measure was sufficient in identifying tobacco users. Including adverse childhood experiences in community needs assessments provides important information for tobacco control efforts and prevention of chronic disease.

Pattern and Predictors of Tobacco Use Among Undergraduates in Three Tertiary Institutions in North-Western Nigeria.

Tobacco use is associated with medical, social and economic problems. There is paucity of data on tobacco use among undergraduates in northern Nigeria. This study assessed pattern and predictors of tobacco use among undergraduates in Zaria, North-western Nigeria. It was a cross-sectional study of undergraduates in three tertiary institutions. Multi-stage sampling technique was used to select 1,080 undergraduates. Data was collected using a questionnaire adapted from Global Adult Tobacco Survey and Global Youth Tobacco Survey. Bi-variate analysis was used to identify independent variables showing statistically significant association with current tobacco use. These were entered into step-wise logistic regression. Their median age was 24 years (range:15-47). Prevalence of current tobacco use was 27.0%. About 58.7% smoked tobacco daily and 40.0% used smokeless tobacco daily. Commonest places where tobacco was used were off campus accommodation (30.2%), social center (30.2%) and bar or club (28.1%). Predictors of tobacco use were being a male [2.64(1.82-3.84)], married [2.33(1.49-3.70)], experiencing tobacco promotional activity [1.56(1.12-2.17)], willing to use promotional objects [2.06(1.35-3.14)], using of promotional objects [2.74(1.90-3.96)], and exposure to secondhand smoke [14.10(4.16-47.81)]. Predictors of non-use of tobacco were spending two years or less awaiting university admission [0.65 (0.46-0.91)], parents currently together [0.48(0.33-0.69)], and supporting ban on tobacco [0.34 (0.23-0.48)]. Prevalence of tobacco use and expenditure on tobacco were high. University authorities should commence programs to identify tobacco users and encourage cessation. The findings also highlight the need to establish effective tobacco surveillance system that includes students of tertiary institutions.

Adolescent measures of family socioeconomic status: Reliability, validity, and effects on substance use behaviors in adolescence and young adulthood.

Socioeconomic status (SES) is a robust predictor of health disparities in adolescence and early adulthood, yet obtaining accurate and reliable measurements of family SES from younger participants remains a challenge. We evaluated the reliability and validity of a subjective SES measure, i.e., perceived family financial security (PFS), which assesses adolescents' perceptions of whether their family has enough money to meet their needs. We also examined the predictive associations of PFS and parental education (adolescent reports) with alcohol, marijuana, and tobacco use during adolescence and young adulthood. Longitudinal data were obtained from 593 parent-child dyads in the Pacific Northwest region of the United States, who were assessed eight times between 2005 and 2014. Present analyses included data from four annual assessments conducted when the participating children were adolescents (age range=10.25-16.33years) and a final follow-up in young adulthood (age range=20-23.42years). PFS had good test-retest reliability and convergent validity with other parent and adolescent reported SES measures. Adolescent-reported PFS significantly predicted tobacco use frequency in young adulthood, whereas adolescent-reported parental education predicted alcohol use frequency. PFS was not a significant predictor of alcohol or marijuana use. Findings suggest that PFS can be a psychometrically sound measure to assess a unique dimension of SES in adolescent samples, with differential predictive associations among substance use outcomes in young adulthood compared to more traditional measures like parental education. Future research should evaluate the psychometric properties and utility of PFS as a complementary SES measure.

Tobacco use patterns and predictors among college students in Mangalore, South India: Findings from the Global Adult Tobacco Survey.

INTRODUCTIONTobacco use is a leading cause of death and disability worldwide, particularly in South-East Asia. The tobacco problem in India is probably more complex than in any other country, with a huge consequential burden of tobacco related diseases and deaths. The present study aimed at analyzing the pattern and predictors of tobacco use among college students aged 18–24 years, using the Global Tobacco Surveillance System (GTSS).METHODSA cross-sectional study was conducted among 2063 students, from 30 colleges of Mangalore, South India, who were selected by multistage sampling with probability proportional to size. The tobacco questions used for this study were a validated, recommended subset of key questions from the Global Adult Tobacco Survey (GATS). Data analysis was performed using GATS manuals and SPSS version 24.0.RESULTSA total of 2063 students participated in the study (738 males, 1325 females). Prevalence of tobacco smoking was 4.8%, which included 9.9% males and 2.1% females. Manufactured cigarettes were the most commonly preferred tobacco product among daily smokers. The overall percentage of smokeless tobacco use was 4.8%, which included 7.4% males and 3.3% females. Logistic regression analysis showed that 71.4% of the participants who noticed anticigarette information on television made an attempt to quit smoking. The odds ratio (OR) of quitting was 4.4 times higher compared to those who did not notice any information on television (p=0.002). In addition, noticing health warnings on cigarette packs strongly influenced an individual to quit smoking (OR=30.09).CONCLUSIONSThe study results showed low prevalence of the use of both smoked and smokeless forms of tobacco, current smoking, and chewing tobacco, among the study population. Generating data in this part of the country on tobacco use and developing tobacco control measures at regular intervals are essential to better understand and develop effective intervention programs.

Personality and impulsivity as predictors of tobacco use among emerging adults: A latent class analysis

The tobacco industry markets their products toward emerging adults (18–29), with the goal of increasing use among this age group. To inform prevention efforts, researchers are investigating how specific demographic and psychological traits may predict tobacco initiation and continuation. Participants were 578 incoming university freshmen from the Appalachian region. Participants provided information on demographics, personality traits, impulsivity characteristics, lifetime use of cigarettes and electronic cigarettes (ECIGs), and current use of cigarettes, ECIGs, small cigars/cigarillos, large cigars, smokeless tobacco, and waterpipe. Latent class analysis identified tobacco-use classes and regressions identified psychological predictors of class membership. Participants were Nonusers, Experimenters, and Polytobacco Users. Lower agreeableness and conscientiousness as well as higher extraversion and neuroticism were associated with being Experimenters or Polytobacco Users. Lower impulsivity was associated with being Nonusers. Distinct types of emerging adults belong to each tobacco use class, suggesting that individual differences be incorporated in prevention efforts.

Family and School Predictors of Tobacco Use in Chilean Adolescents Aged 13 - 14: A National Study

Objectives: Adolescent smoking is a major health care concern which calls for a more in-depth study of the factors affecting this pediatric disease. We aimed to determine the prevalence of tobacco use among Chilean adolescents aged 13 - 14 and its association with family and school factors. Methods: This was a cross-sectional analytical study. Data from the Eleventh Chilean National Study of Drugs in the School Population 2015 were used (n = 11,791). School and family variables of parental control were evaluated and analyzed by the chi-Square test and a multivariate logistic regression model. Data were processed with the STATA V. 14.0 software at the α = 0.05 level of significance. Results: The prevalence of tobacco use at some time during life was 36% with onset age of 11.4 ± 3.6 years. Girls smoke proportionally more than boys (40.5% and 31.5%, respectively). Parental monitoring decreased use and acted as a protective factor (OR: 0.41, 95%CI: 0.375 - 0.468); likewise for good school performance (OR: 0.52, 95%CI: 0.475 - 0.584). In turn, running away from school raises the risk of smoking (OR: 2.34, 95%CI: 2.03 - 2.72). Conclusions: There is a feminization of cigarette use, and the risk of cigarette smoking increases considerably among adolescents who run away from school. However, parental control and school performance are powerful protective factors against early tobacco use.

The relationship between unfair treatment and tobacco use: A national longitudinal Chinese sample.

The aim of present study is to contribute to the literature by examining the developmental relationship between unfair treatment and tobacco use in a national longitudinal Chinese sample. Linear mixed model was used to analyze data from a national longitudinal survey, which measured unfair treatment and tobacco use in 33,600 adults in 4 waves from 2010-2016. The results showed that unfair treatment positively predicted tobacco use and the prediction was consistent over time.Our findings imply that reducing unfair treatment may be an effective way to prevent tobacco use, which is one of the leading causes of preventable morbidity and mortality all over the world.

Student Tobacco Use Behaviors on College Campuses by Strength of Tobacco Campus Policies.

To examine the association between strength of policy and self-reported tobacco use behavior, controlling for demographic characteristics, polytobacco use, knowledge of campus tobacco policy, and perceived policy compliance by others. Cross-sectional, online survey. Ten participating State University of New York (SUNY) campuses; 5 with designated smoking/tobacco use areas and 5 with 100% tobacco-free policies. Convenience sample of students from SUNY campuses: only tobacco users (N = 576 students) included for analysis. Items assessing tobacco use behaviors on campus, policy knowledge, and observation of others using tobacco on campus. T tests and chi-square tests of association used to compare responses between tobacco users across campuses. Generalized estimating equations modeling used to evaluate predictors of tobacco use on campus; model estimated with students nested within campus. Those on campuses without a comprehensive policy were more likely to report (in the past week) having seen others smoke on campus (98% vs 69%, P < .001), having personally smoked on campus (65% vs 36%, P < .001), and seeing others use tobacco products on campus (88% vs 67%, P < .001), compared to those on tobacco-free campuses. Tobacco-free campus policies provide numerous protective factors for tobacco users and nonusers. However, compliance strategies are imperative for intended policy success.

Sex Differences in Associations Between Depression and Posttraumatic Stress Disorder Symptoms and Tobacco Use Among Veterans of Recent Conflicts.

Background: Rates of tobacco use, posttraumatic stress disorder (PTSD), and depression are higher for veterans compared to their civilian counterparts. Female veterans have high rates of tobacco use and mental health (MH) conditions; however, little is known about sex differences in the association of depression and PTSD symptoms with postdeployment tobacco use. Methods: Cross-sectional associations and binary logistic regression models were conducted using baseline interview data from the Survey of Experiences of Returning Veterans sample (850 recently returned veterans; 352 women; age mean [standard deviation, SD] = 35.63 [8.94]; 71.2% white). Results: Men were more likely to be tobacco users (39.8% vs. 23.6%; chi square = 24.40; p < 0.001) and had higher postdeployment PTSD symptoms (men mean [SD] = 48.62 [17.93], women mean [SD] = 45.95 [18.22], t = -2.12, p < 0.05), but had similar rates of depression compared to women. In binary logistic models, sex, depression, and PTSD symptoms showed significant main effects in the prediction of postdeployment tobacco use, over and above the effects of demographics, military variables, and alcohol use. Sex moderated the association between PTSD symptoms and tobacco use, such that PTSD symptoms predicted tobacco use for women, but not for men. Sex did not moderate the association between depression and tobacco use. Conclusions: Given the divergent predictors of postdeployment tobacco use for male and female veterans, there may be sex-specific barriers to tobacco-use cessation, including factors related to MH conditions such as PTSD. Further examination of sex differences can help to identify tailored intervention strategies.

Pattern and Predictors of Tobacco Use in India: Evidence from National Family Health Survey (2015–2016)

Tobacco use continues to be of research interest due to the significant amount of tobacco-attributable non-communicable diseases and deaths in India. This study examines the pattern and predictors of smoking, chewing, and any tobacco use among adults of age 15–49 years in India. This study used secondary data from the fourth round of the National Family and Health Survey (NFHS, 2015–2016) which collected information on tobacco use from men and women in the age group 15–49 ( n = 803097). Bivariate and multivariate analyses were conducted to understand the socio-economic and demographic predictors. GIS maps have been used to show inter-state variation in smoking, chewing, and any tobacco use by gender. About one out of every ten adults aged 15–49 use any tobacco, predominantly in chewing forms. Women are significantly less likely to smoke (odds ratio [OR]: 0.05, confidence interval [CI]: 0.04–0.05), chew (OR: 0.25, CI: 0.24–0.25), and use any tobacco (OR: 0.14, CI: 0.13–0.14) compared with men. Tobacco usage was found more common among the uneducated and economically weak people. There is considerable inter-state heterogeneity in the prevalence and type of tobacco use, and adults in the north-east region are among the most vulnerable population subgroups. Tobacco use continues to be a significant burden due to its magnitude and different forms of use in India. The higher use among males, illiterates, economically weak, socially backward and alcohol users suggest the need for targeted efforts to improve their knowledge and awareness about the harmful effects of tobacco use and stronger enforcement of tobacco control policies.

Predictors of Tobacco Use Among Pediatric Cancer Survivors during Adolescence

Purpose: The advent of research, diagnostic techniques, and treatment protocols has led to an increase in the rate of cancer survival among children diagnosed with cancer before age 20 years with the five-year survival rate at 83% (National Cancer Institute, 2017). Late effects as a result of intense treatments and increased life expectancies augment the risk of health problems in childhood cancer survivors (Soliman & Agresta, 2008; Children’s Oncology Group, 2013). Lifestyle factors, such as tobacco use are known …

Predictors of Tobacco Use Among Pediatric Cancer Survivors during Adolescence

Predictors of Tobacco Use Among Pediatric Cancer Survivors during Adolescence

Sex and sexual orientation in relation to tobacco use among young adult college students in the US: a cross-sectional study

BackgroundSexual minority young adults represent a high-risk population for tobacco use. This study examined cigarette and alternative tobacco product (ATP) use prevalence across sexual orientation (heterosexual, gay/lesbian, and bisexual) among college-attending young adult men and women, respectively.MethodsBaseline data from a two-year longitudinal study of 3386 young adult college students aged 18–25 in Georgia were analyzed. Correlates examined included sociodemographics (age, sex, sexual orientation, race/ethnicity, college type, and parental education). Outcomes included past 30-day use of tobacco (cigarette, little cigars/cigarillos [LCCs], e-cigarettes, hookah, any tobacco product used, and number of tobacco products used, respectively). Two-group, multivariate multiple regression models were used to examine predictors of tobacco use among men and women, respectively.ResultsAmong men (N = 1207), 34.7% used any tobacco product; 18.6% cigarettes; 12.3% LCCs; 16.8% e-cigarettes; and 14.7% hookah. Controlling for sociodemographics, gay sexual orientation (OR = 1.62, p = 0.012) was associated with higher odds of cigarette use; no other significant associations were found between sexual orientation and tobacco use. Among women (N = 2179), 25.3% used any tobacco product; 10.4% cigarettes; 10.6% LCCs; 7.6% e-cigarettes; and 10.8% hookah. Being bisexual was associated with cigarette (p < 0.001), LCC (p < 0.001), and e-cigarette use (p = 0.006). Lesbian sexual orientation was associated with cigarette (p = 0.032) and LCC use (p < 0.001). Being bisexual predicted any tobacco product used (p = 0.002), as well as number of tobacco products used (p = 0.004). Group comparisons showed that the effect of sexual minority status on LCC use was significantly different for men versus women.ConclusionSexual minority women, especially bisexual women, are at higher risk for using specific tobacco products compared to heterosexual women; homosexual men are at increased risk of cigarette use compared to heterosexual men. These nuances in tobacco use should inform interventions targeting sexual minorities.

Mental Health Problems and Onset of Tobacco Use Among 12- to 24-Year-Olds in the PATH Study

To examine whether mental health problems predict incident use of 12 different tobacco products in a nationally representative sample of youth and young adults. This study analyzed Wave (W) 1 and W2 data from 10,533 12- to 24-year-old W1 never tobacco users in the Population Assessment of Tobacco and Health (PATH) Study. Self-reported lifetime internalizing and externalizing symptoms were assessed at W1. Past 12-month use of cigarettes, electronic nicotine delivery systems (ENDS), traditional cigars, cigarillos, filtered cigars, pipe, hookah, snus pouches, other smokeless tobacco, bidis and kreteks (youth only), and dissolvable tobacco was assessed at W2. In multivariable regression analyses, high-severity W1 internalizing (adjusted odds ratio [AOR]= 1.5, 95% CI= 1.3-1.8) and externalizing (AOR= 1.3, 95% CI= 1.1-1.5) problems predicted W2 onset of any tobacco use compared to no/low/moderate severity. High-severity W1 internalizing problems predicted W2 use onset across most tobacco products. High-severity W1 externalizing problems predicted onset of any tobacco (AOR= 1.6, 95% CI= 1.3-1.8), cigarettes (AOR= 1.4, 95% CI= 1.0-2.0), ENDS (AOR= 1.8, 95% CI= 1.5-2.1), and cigarillos (AOR= 1.5, 95% CI= 1.0-2.1) among youth only. Internalizing and externalizing problems predicted onset of any tobacco use. However, findings differed for internalizing and externalizing problems across tobacco products, and by age, gender, and race/ethnicity. In addition to screening for tobacco product use, health care providers should screen for a range of mental health problems as a predictor of tobacco use. Interventions addressing mental health problems may prevent youth from initiating tobacco use.

Prevalence and Predictors of Tobacco Use Among School Adolescents in Zakho, Kurdistan Region of Iraq

Knowledge regarding the smoking prevalence among the Kurdistan general population is not clear, at least for males. Here in the Kurdistan Youth Smoking Survey and Behaviours (KYSS&amp;B) we tried to further expand our knowledge about the smoking profile of school students across Kurdistan. Five hundred students from four Zakho male basic schools were taken to participate in the study to determine the prevalence of smoking and socio-demographical factors associating with smoking among students aged 12 to 15 years. The KYSS&amp;B questionnaire included various parameters such as age, gender, friends, parent history and blood groups. This study showed that the prevalence of students who ever tried smoking was 74%; about 65% of them started at age 12 years or less. Although the majority of participants (95%) knew that smoking is harmful and had negative impact on human health, 18% of them thought that they will never quit smoking. The study concluded that there was no strong association between family monthly income, parent education level and blood groups. On the other hand, the three most critical factors connected with smoking habit reported by students were age, peer influence and father smoking.

Prevalence and predictors of tobacco use among Bhutanese adolescents

Purpose The purpose of this paper is to examine the prevalence of tobacco use and associated factors influencing the use of tobacco among adolescents in a school setting. Design/methodology/approach A cross-sectional descriptive study was conducted amongst Bhutanese adolescents studying at high schools in the district of Wangdue Phodrang in May 2016. A total of 378 eighth-grade students from four schools participated in the study. A self-administered questionnaire was used to collect data. Bivariate and multivariate logistic regressions were carried out to describe the predictors of tobacco use. Findings Of the 378 student participants, 52.90 percent were girls and 47.10 percent boys. The age ranged from 11 to 19 years, and the majority lived in school hostels (82 percent). The prevalence of smoking was 10.80 percent while smokeless tobacco users constituted 11.10 percent in the month preceding the study. Gender, tobacco use by siblings and friends, ever having tried alcohol, consumption of alcohol in the last 30 days, previous experimentation with cigarettes/bidi and smokeless tobacco/baba (p-value &lt;0.05) were significantly related to the use of tobacco among students. In multivariate analysis, tobacco use by friends (AdjOR=1.09; 95%CI=0.01–2.48), ever having tried alcohol (AdjOR=2.24; 95%CI=1.75–3.72), current alcohol use (AdjOR=2.63; 95%CI=1.52–4.31), experimentation with cigarettes/bidi (AdjOR =39.46; 95%CI=11.91–90.63) or with smokeless tobacco/baba (AdjOR=32.61; 95%CI=11.78–90.30) were observed as the strong predictors of current tobacco use among adolescents. Originality/value These study results re-emphasized the rising public health concern of tobacco use among younger boys and girls. The findings may help the Bhutanese policy makers and managers to better understand the present situation of adolescent tobacco use and its associated determinants, and formulate appropriate tobacco control strategies for adolescents.