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Nyman J, Salanterä S, Pasanen M, Parisod H. Effectiveness of a Digital Health Game Intervention on Early Adolescent Smoking Refusal Self-Efficacy. HEALTH EDUCATION & BEHAVIOR 2024; 51:562-572. [PMID: 38497462 PMCID: PMC11193316 DOI: 10.1177/10901981241237788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Smoking poses a significant threat to adolescent health because of its immediate and long-term detrimental health effects. Smoking refusal self-efficacy predicts smoking behavior in adolescence. In adolescents' health education, digital interventions are potential tools to support smoking refusal self-efficacy. The aim of this two-arm cluster randomized controlled trial was to evaluate the effectiveness of a digital health game intervention compared with a no-intervention control group on smoking refusal self-efficacy in 10- to 13-year-old Finnish early adolescents. The early adolescents (n = 781) were randomized to the control group (n = 394) and the health game intervention group (n = 387). Smoking refusal self-efficacy, sources of smoking and snus refusal self-efficacy, and motivation to decline smoking and snus use in the future were measured at baseline, 2-week postintervention, and 3-month follow-up. Data were analyzed using linear mixed model and Wilcoxon rank-based test for clustered data. According to the results, the intervention group made improvements in sources of smoking and snus refusal self-efficacy between baseline and postintervention, and in sources of snus refusal self-efficacy between baseline and follow-up, compared with the control group. The intervention group showed improvements in smoking refusal self-efficacy among 12-year-olds between baseline and follow-up, and postintervention and follow-up compared with the control group. Similar improvements were also found among those with a smoking friend or a smoking parent between postintervention and follow-up. The results were promising for the use of digital health game interventions to promote early adolescent smoking refusal self-efficacy and preventing smoking experimentation. Further research can evaluate the long-term effects for adolescents.
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Affiliation(s)
| | - Sanna Salanterä
- University of Turku, Turku, Finland
- Turku University Hospital, Turku, Finland
| | | | - Heidi Parisod
- University of Turku, Turku, Finland
- Nursing Research Foundation sr, Helsinki, Finland
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Hoffman CM, Versluis A, Chirila S, Kirenga BJ, Khan A, Saeed S, Sooronbaev T, Tsiligianni I, Arvind DK, Bauld LC, van den Brand FA, Chavannes NH, Pinnock H, Powell PD, van der Schans J, Siddiqi K, Williams S, van der Kleij MJJR. The FRESHAIR4Life study: Global implementation research on non-communicable disease prevention targeting adolescents' exposure to tobacco and air pollution in disadvantaged populations. NPJ Prim Care Respir Med 2024; 34:14. [PMID: 38834570 DOI: 10.1038/s41533-024-00367-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/03/2024] [Indexed: 06/06/2024] Open
Abstract
The FRESHAIR4Life study aims to reduce the non-communicable disease (NCD) burden by implementing preventive interventions targeting adolescents' exposure to tobacco use and air pollution (AP) worldwide. This paper presents the FRESHAIR4Life methodology and initial rapid review results. The rapid review, using various databases and PubMed, aimed to guide decision-making on risk factor focus, target areas, and populations. It showed variable NCD mortality rates related to tobacco use and AP across the participating countries, with tobacco as the main risk factor in the Kyrgyz Republic, Greece, and Romania, and AP prevailing in Pakistan and Uganda. Adolescent exposure levels, sources, and correlates varied. The study will continue with an in-depth situational analysis to guide the selection, adaptation, and integration of evidence-based interventions into the FRESHAIR4Life prevention package. This package will be implemented, evaluated, assessed for cost-effectiveness, and iteratively refined. The research places a strong emphasis on co-creation, capacity building, and comprehensive communication and dissemination.
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Affiliation(s)
- Charlotte M Hoffman
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Anke Versluis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Sergiu Chirila
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Bruce J Kirenga
- Lung Institute & Department of Medicine, Makerere University, Kampala, Uganda
| | | | - Saima Saeed
- Indus Hospital and Health Network, Karachi, Pakistan
| | - Talant Sooronbaev
- National Center of Cardiology and Internal Medicine named after academician Mirrakhimov, Bishkek, Kyrgyzstan
| | | | - D K Arvind
- School of Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Linda C Bauld
- Usher Institute and SPECTRUM Consortium, University of Edinburgh, Edinburgh, UK
| | - Floor A van den Brand
- Department of Family Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Hilary Pinnock
- Allergy and Respiratory Research Group, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Jurjen van der Schans
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
| | - Siân Williams
- International Primary Care Respiratory Group, London, UK
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Terefe B, Jembere MM, Chekole B, Assimamaw NT, Gebeyehu DA. Frequency of cigarette smoking and its associated factors among men in East Africa: a pooled prevalence analysis of national survey using multinomial regression. BMC Public Health 2024; 24:668. [PMID: 38429672 PMCID: PMC10908029 DOI: 10.1186/s12889-024-18188-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/22/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Despite the harmful effects of smoking, there have been few studies to pinpoint the factors of this habit, and little is known about it in the East African region. For this reason, this study sought to determine the frequency and factors of cigarette smoking among men in the region. METHODS Data from recent demographic and health surveys carried out in ten East African countries between 2015 and 2022 were analyzed in this study. Data from 87,022 men was collected. The key factors affecting the smoking rates in the area were investigated using binary and multiple multinomial logistic regression. To ascertain if variables were statistically significant in the final model for binary regression and multiple regression, P values of ≤ 0.2 and < 0.05 were used respectively. RESULTS Overall, about 14.69% of people currently smoke cigarettes. Of this about 11.03 (95% CI = 10.82, 11.24) was for daily active tobacco use. As compared to < 26-year-old men, men with an age range of 26-35 years (RRR = 2.17, 95% CI: 2.01,2.34), 36-45 years (RRR = 2.82, 95% CI: 2.60, 3.07), and > 45 years old (RRR = 3.68, 95% CI: 3.38, 4.02), were using cigarettes daily rather than no-smoking cigarettes. Men who had begun their first sexual intercourse at the age of 7-19 years (RRR = 6.27,95% CI, 5.35,7.35), 20-25 years (RRR = 4.01, 95% CI, 3.40,4.72), and greater than 25 years old (RRR = 3.08, 95% CI, 2.55,3.71) have shown a higher relative risk ratio to smoke cigarette daily rather than using not smoke cigarette respectively, married (RRR = 0.86, 95% CI, 0.79,0.93), divorced or widowed (RRR = 2.51, 95% CI, 2.27,2.77), middle wealth index (RRR = 2.11, 95% CI 1.98,2.24), and rich (RRR = 1.44, 95% CI, 1.34,1.54), secondary/higher education (RRR = 0.72, 05% CI, 0.66,0.77), rural men (RRR = 0.69, 95% CI, 0.65,0.73), employed men (RRR = 1.26,95% CI, 1.17,1.36), mass media exposure (RRR = 0.76, 95% CI, 0.73,0.81), men who have one sex partner (RRR = 1.23,95% CI,1.13,1.35), and more than one sex partner (RRR = 1.63, 95% CI, 1.47,1.79) more times as compared to those participants who had no sex partner respectively. CONCLUSIONS Men in East African nations were substantially more likely to smoke cigarettes if they were older, had less education, had a higher wealth index, were divorced or widowed, had many sexual relationships, had early sexual activity, resided in an urban area, were employed, or had no media exposure. The identified factors should be considered by policymakers and public health professionals to lower smoking initiation and increase smoking cessation among men.
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Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Post Office Box: 196, Ethiopia.
| | - Mahlet Moges Jembere
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bogale Chekole
- Department of Comprehensive Nursing, College of Medicine and Health Sciences, Wolkite University, Southern, Ethiopia
| | - Nega Tezera Assimamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Ayelegne Gebeyehu
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Malta DC, Gomes CS, Alves FTA, Oliveira PPVD, Freitas PCD, Andreazzi M. The use of cigarettes, hookahs, electronic cigarettes, and other tobacco indicators among Brazilian schoolchildren: data from National School Health Survey 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022; 25:e220014. [PMID: 35703716 DOI: 10.1590/1980-549720220014.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 03/07/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To describe the prevalence of smoking indicators among Brazilian students according to sociodemographic characteristics in 2019, and compare the prevalence between 2015 and 2019. METHODS Data from the National Survey of School Health 2015 and 2019 were used. Indicators related to tobacco use were analyzed. Indicators were compared between the 2015 and 2019 editions. Prevalence and respective 95% Confidence Interval (95%IC) were calculated for the total population and according to sex, age group and type of school. RESULTS 22.6% (95%CI 21.7-23.4) of the students had tried any cigarette and it was higher between 16 and 17 years of age (32.6%; 95% CI 31.4-33, 8) and in males (35.0%; 95%CI 33.6-36.4). The experimentation of hookah, electronic cigarette and other tobacco products are also high, with 26.9% (95%CI 26.0-27.8), 16.8% (95%CI 16.2-17.4) and 9.3% (95%CI 8.8-9.8), respectively, being higher among boys aged 16 to 17 years. It is noteworthy that there were no changes in the indicators of cigarette experimentation, smoking for the first time before the age of 13, smoking in the 30 days prior to the survey, and at least one of the smoking parents. CONCLUSION Although smoked tobacco indicators are stable between 2015 and 2019, the high prevalence of experimentation with products such as hookah and electronic cigarettes is highlighted, drawing attention to the need for new regulatory measures.
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Affiliation(s)
- Deborah Carvalho Malta
- Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Saúde Pública - Belo Horizonte (MG), Brasil
| | - Crizian Saar Gomes
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Saúde Pública - Belo Horizonte (MG), Brasil
| | | | | | | | - Marco Andreazzi
- Instituto Brasileiro de Geografia e Estatística, Diretoria de Pesquisa - Rio de Janeiro (RJ), Brasil
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Tarasenko Y, Ciobanu A, Fayokun R, Lebedeva E, Commar A, Mauer-Stender K. Electronic cigarette use among adolescents in 17 European study sites: findings from the Global Youth Tobacco Survey. Eur J Public Health 2022; 32:126-132. [PMID: 34694383 PMCID: PMC8807119 DOI: 10.1093/eurpub/ckab180] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND As new findings on public health implications of electronic cigarette (e-cigarette) use emerge, its surveillance remains of utmost importance. This study examined the latest state of e-cigarette use in youth in 17 European study sites (i.e. 16 countries and the Federation of Bosnia and Herzegovina) using the Global Youth Tobacco Survey (GYTS). METHODS This was an observational study. Cross-sectional data on students aged 11-17 years from the latest available GYTS round completed in 17 study sites were used to estimate crude and adjusted prevalence of e-cigarette use by sex and pocket money. Panel GYTS data from five countries were used for the trend analyses. All analyses were weighted to account for the survey design and non-response. RESULTS Compared to 2014, the age-adjusted prevalence of e-cigarette use more than doubled in Georgia and Italy, and nearly doubled in Latvia. Significantly more male than female students aged 11-17 years reported use of e-cigarettes, with little to no confounding by age, grade and pocket money across countries. Youth with medium or higher amount of pocket money was 20-200% more likely to use e-cigarettes than those with fewer to no pocket money in 14 study sites. DISCUSSION As e-cigarette use is becoming widespread throughout the world, there is variation in use among and between countries. Expanded and consistent surveillance of e-cigarette use by all World Health Organization member states is essential to generate data on the extent and correlates of youth e-cigarette use for evidence-based planning and evaluation of the electronic nicotine delivery systems and electronic non-nicotine delivery systems national and global control programmes.
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Affiliation(s)
- Yelena Tarasenko
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
- Division of Country Health Programmes, Regional Office for Europe, World Health Organization, WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Angela Ciobanu
- Division of Country Health Programmes, Regional Office for Europe, World Health Organization, WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Ranti Fayokun
- No Tobacco Unit, Healthier Populations Division, Health Promotion Department, World Health Organisation, Geneva, Switzerland
| | - Elizaveta Lebedeva
- Division of Country Health Programmes, Regional Office for Europe, World Health Organization, WHO European Office for the Prevention and Control of NCDs, Moscow, Russian Federation
| | - Alison Commar
- No Tobacco Unit, Healthier Populations Division, Health Promotion Department, World Health Organisation, Geneva, Switzerland
| | - Kristina Mauer-Stender
- Division of Country Support and Emergencies, Regional Office for Europe, World Health Organization, Copenhagen, Denmark
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Polanska K, Znyk M, Kaleta D. Susceptibility to tobacco use and associated factors among youth in five central and eastern European countries. BMC Public Health 2022; 22:72. [PMID: 35016662 PMCID: PMC8753878 DOI: 10.1186/s12889-022-12493-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 12/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Tobacco use among young people still remains a major public health problem. Thus, the aim of this study was to perform a cross-country comparison for the factors associated with susceptibility to tobacco use among youth from five central and eastern European countries. Methods The data used in the current analysis, focusing on youth (aged 11–17 years), who have never tried or experimented with cigarette smoking, was available from the recent Global Youth Tobacco Survey (Czech Republic (2016), n = 1997; Slovakia (2016), n = 1998; Slovenia (2017), n = 1765; Romania (2017), n = 3718; Lithuania (2018), n = 1305). Simple, multiple logistic regression analyses and random-effect meta-analysis were conducted to identify factors associated with tobacco use susceptibility as the lack of a firm commitment not to smoke. Results Nearly a quarter of the students were susceptible to tobacco use in 4 of 5 countries. The following factors were identified, consistently across countries, as correlates of tobacco use susceptibility: exposure to passive smoking in public places (AOR from 1.3; p = 0.05 in Slovakia to 1.6; p < 0.01 in Czech Republic and Romania), peers smoking status (AOR from 1.8 p < 0.01 in Slovakia to 2.5; p < 0.01 Lithuania), opinion that smoking helped people feel more comfortable at celebrations (AOR from 1.3; p = 0.01 in Czech Republic to 1.9; p < 0.01 in Lithuania), noticing people using tobacco in mass media (AOR 1.5; p < 0.01 in Slovenia and 1.6; p < 0.01 in Lithuania), lack of knowledge on harmful effects of passive smoking (AOR 1.8; p < 0.01 in Slovakia and 2.4; p < 0.01 in Slovenia), lack of antismoking education provided by school (AOR 1.3; p < 0.05 in Czech Republic, Slovakia and Slovenia; 1.9; p < 0.01 in Lithuania), and family (AOR 1.5; p < 0.01 in Slovenia and Romania). Moreover those who believed that smoking makes young people look less attractive (AOR from 0.5; p < 0.01 in Romania to 0.7; p = 0.05 in Lithuania) and that people who smoke have less friends (AOR 0.7; p ≤ 0.06) turned out to be less susceptible to tobacco use initiation. In Czech Republic and Slovenia significantly higher susceptibility to tobacco use was observed among females as compared to males (AOR 1.4; p < 0.01), whereas in Romania opposite pattern, although not significant, was observed (p = 0.3). Having more money available for own expenses, positively correlated with smoking suitability in all countries (AOR > 1.5; p < 0.01) except Lithuania where youth with more money available tend to be less susceptible to tobacco use (p > 0.05). Youth who share the opinion that people who smoke have more friends were more susceptible to smoking in Romania (AOR 1.4; p = 0.04) but tend to be less susceptible in other countries. Exposure to advertisements at points of sale was significant correlate of tobacco use susceptibility in Slovakia and Slovenia (AOR 1.4 and 1.5 respectively; p < 0.05), with moderate heterogeneity between the countries. Conclusions A high proportion of youth from central and eastern European countries was susceptible to tobacco use. Social factors, and those related to educational and policy issues as well as to attitudes regarding tobacco use were strongly, and consistently across countries, correlated with tobacco use susceptibility. Slight differences in susceptibility to tobacco use between the countries were related to: sex, money available for own expenses, exposure to advertisements at points of sale and opinion that people who smoke have more friends. These factors should be considered when designing and implementing anti-tobacco activities among young people. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12493-6.
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Malta DC, Gomes CS, Alves FTA, Oliveira PPVD, Freitas PCD, Andreazzi M. The use of cigarettes, hookahs, electronic cigarettes, and other tobacco indicators among Brazilian schoolchildren: data from National School Health Survey 2019. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2022. [DOI: 10.1590/1980-549720220014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT: Objective: To describe the prevalence of smoking indicators among Brazilian students according to sociodemographic characteristics in 2019, and compare the prevalence between 2015 and 2019. Methods: Data from the National Survey of School Health 2015 and 2019 were used. Indicators related to tobacco use were analyzed. Indicators were compared between the 2015 and 2019 editions. Prevalence and respective 95% Confidence Interval (95%IC) were calculated for the total population and according to sex, age group and type of school. Results: 22.6% (95%CI 21.7-23.4) of the students had tried any cigarette and it was higher between 16 and 17 years of age (32.6%; 95% CI 31.4-33, 8) and in males (35.0%; 95%CI 33.6-36.4). The experimentation of hookah, electronic cigarette and other tobacco products are also high, with 26.9% (95%CI 26.0-27.8), 16.8% (95%CI 16.2-17.4) and 9.3% (95%CI 8.8-9.8), respectively, being higher among boys aged 16 to 17 years. It is noteworthy that there were no changes in the indicators of cigarette experimentation, smoking for the first time before the age of 13, smoking in the 30 days prior to the survey, and at least one of the smoking parents. Conclusion: Although smoked tobacco indicators are stable between 2015 and 2019, the high prevalence of experimentation with products such as hookah and electronic cigarettes is highlighted, drawing attention to the need for new regulatory measures.
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Ma C, Heiland EG, Li Z, Zhao M, Liang Y, Xi B. Global trends in the prevalence of secondhand smoke exposure among adolescents aged 12-16 years from 1999 to 2018: an analysis of repeated cross-sectional surveys. LANCET GLOBAL HEALTH 2021; 9:e1667-e1678. [PMID: 34571047 DOI: 10.1016/s2214-109x(21)00365-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Secondhand smoke exposure can cause morbidity and premature mortality. However, the global prevalence of, and trends in, secondhand smoke exposure among adolescents are poorly documented. We aimed to assess the prevalence of, and trends in, secondhand smoke exposure among adolescents from 1999 to 2018. METHODS We did an analysis of the most recent data from the Global Youth Tobacco Survey (GYTS), a nationally representative, self-administered, school-based cross-sectional survey of tobacco use and related factors among adolescents aged 12-16 years worldwide. Data from 142 countries and territories that had done a GYTS between 2010 and 2018, comprising 711 366 participants, were used to assess the prevalence of secondhand smoke exposure. Data from 131 countries and territories that had done two or more surveys between 1999 and 2018, comprising 1 405 458 participants, were used to assess trends in secondhand smoke exposure. The frequency of secondhand smoke exposure at home, in public places, or in any place was defined as follows, based on students' responses: 1 or more days, 3 or more days, 5 or more days, or daily during the past 7 days. FINDINGS Based on the most recent surveys done in 142 countries between Jan 1, 2010, and Dec 31, 2018, the global prevalence of secondhand smoke exposure in any place was 62·9% (95% CI 61·7-64·1) on 1 or more days, 51·0% (49·8-52·1) on 3 or more days, 40·1% (38·9-41·2) on 5 or more days, and 32·5% (31·5-33·6) daily during the past 7 days. The prevalence of secondhand smoke exposure at home was 33·1% (95% CI 32·1-34·1) on 1 or more days, 20·1% (19·3-20·9) on 3 or more days, 14·9% (14·2-15·7) on 5 or more days, and 12·3% (11·7-13·0) daily during the past 7 days; and in public places the prevalence of secondhand smoke exposure was 57·6% (56·4-58·8) on 1 or more days, 43·4% (42·2-44·6) on 3 or more days, 30·3% (29·2-31·5) on 5 or more days, and 23·5% (22·5-24·5) daily during the past 7 days. Between Jan 1, 1999, and Dec 31, 2018, the prevalence of secondhand smoke exposure (on ≥1 day during the past 7 days) in any place decreased in 57 (43·5%) of 131 countries, increased in 27 (20·6%), and remained unchanged in 47 (35·9%). Although the prevalence of secondhand smoke exposure at home decreased in 86 (65·6%) countries, the prevalence in public places did not change in 46 (35·1%) countries and increased in 40 (30·5%). INTERPRETATION Secondhand smoke exposure among adolescents remains a serious public health challenge worldwide. Although the prevalence of secondhand smoke exposure at home decreased in most countries, the prevalence in public places increased or remained unchanged in most countries between 1999 and 2018. These findings emphasise the need to strengthen smoke-free policies, especially in public places. FUNDING Youth Team of Humanistic and Social Science of Shandong University, Jinan, China. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Chuanwei Ma
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Emerald G Heiland
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences (GIH), Stockholm, Sweden
| | - Zilin Li
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
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LOGO DIVINED, OPPONG FELIXB, SINGH ARTI, AMENYAGLO SEIDU, WIRU KENNETH, ANKRAH SAMPSONT, MUSAH LABRAMM, KYEI-FARIED SARDICK, ANSONG JOANA, OWUSU-DABO ELLIS. Profile and predictors of adolescent tobacco use in Ghana: evidence from the 2017 Global Youth Tobacco Survey (GYTS). JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E664-E672. [PMID: 34909494 PMCID: PMC8639124 DOI: 10.15167/2421-4248/jpmh2021.62.3.2035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/09/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Understanding the predictive factors for tobacco use, and initiation among the youth is critical for effective intervention and prevention. We, therefore, aimed to determine the profile, associated factors, the regional disparities in the use of tobacco products among the youth in Ghana. METHOD The study used the 2017 Ghana Global Youth Tobacco Survey (GYTS) to obtain tobacco-related information among the youth in Junior High Schools across the country. The survey used a two-stage cluster randomized sampling technique to obtain nationally representative data. Weighted univariate and multivariate logistic regression analyses were used to assess the association of participant's characteristics and use of tobacco. RESULTS Out of the 6039 targeted respondents, 5,664 (93.8%) participated, 2,707 males, 2,929 females, and 28 of the participants had missing gender data. The use of any tobacco product (cigarette, smokeless tobacco, electronic cigarette, or waterpipe tobacco) was 28.3, 7.0, and 4.8% in the Savanna/northern zone, middle/forest zone, and Coastal zone respectively. From the univariate analysis, age (p = 0.005), pocket money (p < 0.001), and exposure to secondhand smoke (SHS) at home (p < 0.001) were significantly associated with tobacco use. In the multivariate analysis, age (p = 0.002), pocket money (p < 0.001), exposure to SHS at home (p < 0.001), and being taught about the dangers of tobacco use (p = 0.043) were significantly associated with tobacco use. CONCLUSION Multiple factors including age, pocket money, exposure to SHS were identified to be associated with tobacco use among the youth in Ghana. Promoting anti-smoking campaigns in early adolescence, as well as programmes targeting early tobacco use can guard the youth against initiating tobacco use.
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Affiliation(s)
- DIVINE D. LOGO
- Research and Development Division, Ghana Health Service, Accra, Ghana
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - ARTI SINGH
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - SEIDU AMENYAGLO
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - KENNETH WIRU
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - SAMPSON T. ANKRAH
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - JOANA ANSONG
- World Health Organization Ghana Country Office, Accra, Ghana
| | - ELLIS OWUSU-DABO
- Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Prevalence and trends in tobacco use among adolescents aged 13-15 years in 143 countries, 1999-2018: findings from the Global Youth Tobacco Surveys. THE LANCET CHILD & ADOLESCENT HEALTH 2021; 5:245-255. [PMID: 33545071 DOI: 10.1016/s2352-4642(20)30390-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/26/2020] [Accepted: 12/02/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Tobacco use is a leading preventable cause of morbidity and mortality worldwide. Little is known about recent prevalence and trends in tobacco use among adolescents globally. We aimed to assess the recent global prevalence of tobacco use in young adolescents and the secular trends in prevalence between 1999 and 2018. METHODS We used the most recent Global Youth Tobacco Surveys data on adolescents aged 13-15 years from 143 countries or territories that had done at least one survey between Jan 1, 2010, and Dec 31, 2018, to assess the recent prevalence of tobacco use; and data from 140 countries that had done two or more surveys between Jan 1, 1999, and Dec 31, 2018, to assess the trends in the prevalence of tobacco use. FINDINGS 530 234 adolescents were included from the 143 countries that had done at least one survey between 2010 and 2018. 1 192 312 adolescents were included from the 140 countries that had done two or more surveys between 1999 and 2018. The most recent global prevalence of cigarette smoking was 11·3% (95% CI 10·3-12·3) in boys and 6·1% (5·6-6·6) in girls, based on cigarette smoking on at least 1 day during the past 30 days, 6·0% (5·5-6·6) and 2·6% (2·4-2·9) based on smoking on at least 3 days, and 4·2% (3·8-4·6) and 1·6% (1·4-1·8) based on smoking on at least 6 days. The most recent prevalence of the use of tobacco products other than cigarettes (eg, chewing tobacco, snuff, dip, cigars, cigarillos, pipe, electronic cigarettes) on at least 1 day during the past 30 days was 11·2% (9·9-12·6) in boys and 7·0% (6·4-7·7) in girls. The most recent prevalence of any tobacco use on at least 1 day during the past 30 days was 17·9% (16·1-19·6) in boys and 11·5% (10·5-12·4) in girls. The prevalence of cigarette smoking on at least 1 day during the past 30 days decreased between the first and last surveys in 80 (57·1%) of 140 countries, was unchanged in 39 countries (27·9%), and increased in 21 countries (15·0%). However, the prevalence of the use of tobacco products other than cigarettes was unchanged or increased in 81 (59·1%) of 137 countries. INTERPRETATION The global prevalence of tobacco use among adolescents aged 13-15 years was substantial. Although the prevalence of cigarette smoking decreased over time in the majority of countries, the prevalence of the use of other tobacco products increased or did not change in the majority of countries during the past two decades. These findings re-emphasise the need to strengthen tobacco control efforts among young adolescents globally. FUNDING Shandong University.
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Nicotine Dependence and Loss of Autonomy among Greek Adolescent Smokers: A Countrywide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218191. [PMID: 33167606 PMCID: PMC7664176 DOI: 10.3390/ijerph17218191] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/31/2020] [Accepted: 11/03/2020] [Indexed: 11/26/2022]
Abstract
Nicotine dependence is one of the main reasons for the continuation of smoking among adolescents. Loss of autonomy (LOA) is a measure of dependence. This study is the first to investigate LOA and its determinants among Greek adolescents. In 2013, 13-to-15-year-old middle-school students were selected by multi-stage clustered sampling. LOA was evaluated with the Hooked-on-Nicotine Checklist (HONC). Multiple univariate analysis was used to assess the association between adolescent demographics, smoking habits, and loss of autonomy. Three-hundred thirty-nine current smokers responded to the questionnaire (response rate: 82.3%). Of these respondents, 51.2% were male and 88.8% reported at least one LOA symptom. The mean HONC score was 4.13/10 (95% CI: 3.82–4.45). Higher scores were negatively associated with lower smoking frequency (cumulative odds ratio (cOR): 0.240, 95% CI: 0.144–0.400) and positively associated with lower age at first cigarette (cOR: 2.29, 95% CI: 1.38–3.82). Female gender was significantly associated with the prevalence but not the degree of LOA. Overall, the prevalence and the degree of nicotine dependence among adolescent smokers in Greece is similar to other countries. Frequent smoking and initiation of smoking at a younger age are linked to nicotine dependence, although it was not possible to make causal inferences. The relationship between nicotine dependence and gender remains unclear.
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Lim KH, Ghazali SM, Lim HL, Kee CC, Cheah YK, Singh BSGP, Heng PP, Teh CH, Cheong YL, Lim JH. Tobacco use and other aspects related to smoking among school-going adolescents aged 13-15 years in Malaysia: Analysis of three cross-sectional nationally representative surveys in 2003, 2009 and 2016. Tob Induc Dis 2020; 18:80. [PMID: 33013276 PMCID: PMC7528268 DOI: 10.18332/tid/127231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/12/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Periodic surveys on tobacco use patterns and other aspects of tobacco use among school-going adolescents in Malaysia provide information on the effectiveness of anti-smoking measures implemented. However, such information is limited in Malaysia. We investigated the prevalence of smoking and other related aspects among middle-secondary school students in Malaysia from the years 2003-2016 to fill this gap. METHODS We analyzed data from the Global Youth Tobacco Survey (GYTS) 2003, GYTS 2009, and the Tobacco and Electronic Cigarette Survey among Malaysia Adolescents (TECMA) 2016. The surveys employed multistage sampling to select representative samples of adolescents attending secondary school in Malaysia. Data were collected using a pre-validated self-administered anonymous questionnaire adopted from the GYTS. RESULTS Between 2003 and 2016, major changes occurred in which there were reductions in the prevalence of ever smoking, current smoking, and susceptibility to smoking. Reductions were also observed in exposure to SHS in public places and in the home. The proportion of school-going adolescents who support a ban on smoking in public places increased between 2013 to 2016, and there was a significant reduction in the proportion of respondents that were offered 'free' cigarettes by tobacco company representatives. However, there was no difference in the proportion of adolescents who initiated smoking before the age of 10 years and current smokers seeking advice to quit smoking across the time period. CONCLUSIONS Our study indicates that the smoking policies and measures have been effective in reducing smoking prevalence, secondhand smoke exposure, and access to cigarettes, among school-going adolescents in Malaysia. However, measures to reduce smoking initiation and increase smoking cessation need to be strengthened to reduce the burden of smoking-related diseases in Malaysia in the long-term.
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Affiliation(s)
- Kuang H. Lim
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Sumarni M. Ghazali
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Hui L. Lim
- Department of Oncology, Hospital Sulltan Ismail, Johor Bahru, Malaysia
| | - Chee C. Kee
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
- Sector for Biostatistics and Data Repository, National Institute of Health, Shah Alam, Malaysia
| | - Yong K. Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | | | - Pei P. Heng
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Chien H. Teh
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Yoon L. Cheong
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Jia H. Lim
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
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