Tobacco use in Nigerian youth: A systematic review

Adolescent smoking patterns: Associations with sociodemographic factors, cyberbullying, and psychiatric diagnoses in an outpatient clinical sample

There is a scarcity of research on smoking in adolescents within a clinical (outpatient) sample, and there is no existing knowledge on the relationship between cyberbullying and smoking in this population. The primary aim of this study is to determine the prevalence of smoking among adolescents in a clinical sample. Additionally, it aims to examine the potential associations between smoking status and factors such as socioeconomic characteristics, psychiatric diagnoses, and cyberbullying levels. A cross-sectional study was performed on 200 adolescents who visited a tertiary child and adolescent psychiatry outpatient clinic. Participants were assessed using the DSM-5 based psychiatric evaluation, the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version-DSM-5 Turkish Adaptation (K-SADS-PL-DSM-5-T), the Revised Cyber Bullying Inventory-II, and the Fagerström Test for Nicotine Dependence. The study found that 21% of the sample consisted of regular smokers, with a higher prevalence observed among older adolescents. The prevalence of depression and disruptive behavior disorders was significantly greater in the smoking group compared to other groups (p:0.043, p < 0.001, respectively). There was a significant difference in the scores for the cyberbullying bully subdimension among smokers (p = 0.013). The results of the multinomial logistic regression analysis indicated significant associations between smoking and age, maternal smoking status, friends smoking status, and a diagnosis of disruptive behavior disorder (p < 0.05 for all variables). This study reveals a significant prevalence of adolescent smoking in an outpatient clinic. These findings highlight the necessity of implementing focused smoking cessation interventions for this specific population.

Study of the prevalence of tobacco consumption among apparently healthy adult males in an urban area

Background

Keeping in view the role of tobacco consumption as a modifiable risk factor in various diseases and gaps in scientific knowledge among the apparently healthy adult male population in India, the researchers chose to undertake this study.

Materials and Methods

A cross-sectional study was conducted among apparently healthy adult males employed in various government offices to determine the prevalence of tobacco consumption. The minimum sample size to estimate a 95% confidence interval for the prevalence of tobacco consumption with 5% absolute precision was calculated to be 340. However, 500 subjects were included in the study. The tool used for data collection was the "personal interview technique." Standard statistical methods were utilized for data analysis.

Results

The overall mean age (standard deviation (SD)) of the study subjects was 30.96 yrs (4.32). Overall, the mean (SD) of number of years of tobacco use was 5.64 years (1.98). The mean (SD) of number of cigarettes smoked per day was 6.36 (3.09). The prevalence of current smokers showed a statistically significant increase from the age groups of 20-29 yrs to 50-59 yrs (P < 0.001). All subjects in the study were able to name at least three harmful effects of tobacco consumption. The overall mean amount spent on tobacco consumption per month was Rs 536.97 (1.44% of basic salary). Overall, the most common reason for smoking was peer pressure, where 40 (93.02%) gave this reason. Of forty-three tobacco users, 27 (62.79%) expressed a desire to quit tobacco consumption. The most common reason for expressing a desire to quit tobacco was the ill effects of tobacco consumption, where 23 (85.18%) tobacco users gave this reason.

Conclusion

Our study on the prevalence of tobacco consumption among government employees provides an adequately clear picture of this public health epidemic in India. There is an immediate need for target group-specific policies for tobacco control, which should be integrated with the relevant national health programs at all levels.

Tobacco Vendors' Perceptions and Compliance with Tobacco Control Laws in Nigeria

Tobacco vendors are critical stakeholders in the tobacco supply chain. This study examined their perception, compliance, and potential economic impact of Nigeria's tobacco control laws related to the retail setting. This was a qualitative study involving in-depth interviews of 24 purposively selected tobacco vendors. The face-to-face interviews were aided by a semi-structured interview guide, audio-recorded, transcribed verbatim, and analyzed using thematic analysis with NVivo version 12. Five themes emerged, encompassing reasons for selling tobacco, awareness, perception, compliance with tobacco sales laws, the potential economic impact of the laws, and law enforcement activities. Vendors commenced tobacco sales due to consumers' demand, profit motives, and advice from close family relatives. They were unaware and non-compliant with most of the retail-related laws. Most participants had positive perceptions about the ban on sales to and by minors, were indifferent about the ban on Tobacco Advertising Promotion and Sponsorships (TAPS) and product display, and had negative perceptions about the ban on sales of single sticks. Most vendors stated quitting tobacco sales would not have a serious economic impact on their business. In conclusion, the vendors demonstrated limited awareness and non-compliance with various retail-oriented tobacco control laws in Nigeria. Addressing these gaps requires targeted educational campaigns and effective law enforcement strategies to enhance vendors' compliance.

Sociodemographic predictors of non-communicable diseases risk-related knowledge and behaviours: a cross-sectional study of in-school adolescents in a southern Nigerian State

Introduction

the adolescence period is a significant phase in development of non-communicable diseases. Public health interventions that reduce risky behaviors among adolescents are beneficial across the life course. This study assessed the level of non-communicable diseases (NCDs´) risk-related knowledge, the prevalence of NCDs´ risk behavior, and the sociodemographic predictors of NCDs´ risk-related knowledge and behaviors among in-school adolescents in a Southern Nigerian State.

Methods

a cross-sectional study design was employed to assess the NCDs´ risk-related knowledge and behaviors among a random multistage sample of 607 students age between 10 and 19 years. Data were collected using an interviewer-administered semi-structured questionnaire adapted from the WHO STEPS questionnaire. Descriptive and inferential analyses of data collected were carried out using the IBM SPSS version 22 software.

Results

the mean age of the students was 14.7 (SD=1.52) years, 57.2% (n=347) of which were females, and 42.8% (n=260) were males. The proportion of students with good overall NCDs risk-related knowledge was 22.7% (n=138). Age, place of residence, family's socioeconomic status, and mother's level of education were significant sociodemographic predictors of good overall NCD risk-related knowledge. Among the students, 66.2% (n=402) self-report inadequate physical activity, 65.7% (n=399) self-report consumption of unhealthy diets, 29.2% (n=177) self-report current alcohol use, and 3.3% (n=20) self-report they were current cigarette smokers.

Conclusion

a significant proportion of the surveyed students had poor overall NCDs risk-related knowledge and engaged in NCDs risk behaviors. The relevant stakeholders concern with prevention of NCDs in government and non-governmental organizations should target adolescents in NCD control strategies in the study setting.

Oral health of adolescents in West Africa: prioritizing its social determinants

Oral health is a major public health issue in West Africa, yet it has gotten little attention. Individual and group disparities in health status are influenced by social determinants of health (SDH), which also affect oral health. Adolescence is a significant transition into adulthood, a time when the SDH can contribute to lifelong health status. This article explored the SDH associated with oral health behaviour, perception, and oral health development amongst adolescents in West Africa. This article engaged articles published in peer-reviewed journals relating to adolescents' oral health and West Africa. The authors undertook this desk review to determine the social determinants of adolescents' oral health in West Africa. The literacy levels and oral health awareness of adolescents, family and social circle influences, socioeconomic status, nutritional levels, and cultural and environmental factors have been identified as important social determinants. Adequate policy implementation with the integration of oral health in schools' curriculum, health systems reorientation with the adoption of oral health delivery in primary health care and expansion in oral health research with the assessment of cultural influences on oral health development have been recommended as interventions to reduce oral health inequalities in West Africa.

Exposure to tobacco advertisements, promotions, and sponsorships among in-school adolescents in Lagos, Nigeria: A cross-sectional study

Background

The Nigerian government implemented the National Tobacco Control Act (NTCA) in 2015, which prohibits tobacco advertising, promotion, and sponsorship (TAPS) exposure to children under 18 years of age. This study was conducted to assess the prevalence of attitudes and exposure to TAPS among in-school adolescents in Lagos State, Nigeria, 5 years after the implementation of the Act and to identify the factors associated with TAPS exposure among the adolescents.

Materials and Methods

This cross-sectional study was conducted among 968 in-school adolescents selected through multistage random sampling. The data were collected using self-administered questionnaires adapted from the Global Youth Tobacco Survey.

Results

Overall, 77% had been exposed to at least one form of TAPS in the past 30 days. The most frequently reported channel of exposure was through product placements, with 62% reporting exposure in films, TV, and videos. Up to 15.2% and 12.6% were exposed to TAPS through promotional activities and sponsorships, respectively. The majority (82.3%) had pro-tobacco attitudes, while about a third (33.1%) had pro-TAPS attitudes. Factors associated with TAPS exposure were having pro-TAPS attitudes (odds ratio [OR]: 3.5, 95% confidence interval [CI]: 2.3-5.3), being female (OR: 2, 95% CI: 1.4-2.7), and residing in a rural area (OR: 1.6, 95% CI: 1.2-2.3).

Conclusion

Five years after implementing the NTCA, more than two-thirds of the adolescents reported exposure to TAPS, mainly through films, TV, and videos. This suggests that the NTCA is poorly enforced. Efforts to ensure the effective implementation of comprehensive TAPS bans are warranted. Gender-sensitive strategies that target adolescents' attitudes and school-level factors should be emphasized.

[Prevalence and factors associated with smoking among adults living in the Moungali district of Brazzaville in 2021]

Introduction

tobacco epidemic is a real public health problem in the world and in Africa. The purpose of this study was to estimate the prevalence and identify factors associated with smoking among adults living in the Moungali district.

Methods

we conducted a cross-sectional analytical study of 800 adults. Two-stage random sampling was used to select subjects in the Moungali district, Brazzaville, in September 2021. Binary logistic regression using the ascending stepwise method allowed identification of the associated factors. The adjustment of the model was verified by the Hosmer Lomeshow test. Data were collected via the Kobo collect V1.30.1 app. and analyzed with the Stata 15.0 software.

Results

smoking prevalence was 4.63%, 95% CI [3.37-6.31]. Males (AOR=8.36 95% CI [3.74-18.72], p-value < 0.0001), alcohol consumption (AOR=2.6 95% CI [1.11-6.11], p-value = 0.028), and professional activity (formal or informal sector) (AOR=3.91 95% CI [1.16-13.11], p-value = 0.027) were factors significantly associated with smoking.

Conclusion

this study highlights that smoking is a stronger risk factor in men than in women. In addition, alcohol consumption and professional activity in the formal or informal sector are also factors associated with active smoking. Preventive actions focusing on these factors are necessary to effectively fight smoking in adults.

Knowledge of senior secondary school students in Nigeria about Head and Neck Cancer: Implications on prevention strategies

Background

The high prevalence of the risk factors of head and neck cancer (HNC) amongst senior secondary (high) school students in Nigeria is an issue of serious public health concern. Therefore, this study aimed to assess the knowledge of HNC among them.

Methods

This cross-sectional study surveyed 2,530 senior secondary school students in Nigeria, assessed their knowledge of HNC, using a self-administered questionnaire. Data collected were analyzed using the SPSS version 25 software.

Results

The mean (±SD) age of the respondents was 16.34 (±2.0) years. More than half (1418; 56.6%) of them were males, 530 (20.9%) were schooling in the north-central geopolitical zone of Nigeria, 1,860 (73.5%) were in public schools, 554 (21.9%) were boarding students, and 817 (33.5%) were in Senior Secondary (SS) 3 class. Only 789 (31.2%) respondents were aware of HNC, out of which: 69.2% of them had below-average scores in their overall assessment on HNC; 256 (32.4%) had ever received education on HNC and 81.2% indicated a positive interest in knowing more about HNC. The factors predicting above-average score on knowledge about HNC among the respondents were: being in SS3 class (OR=1.73; 95% CI=1.17 - 2.56), having been educated about HNC (OR=1.69; 95%CI=1.21 - 2.35) and having the interest to know more about HNC (OR=1.88; 95%CI=1.21 - 2.92). Bivariate analysis showed that these factors had statistically significant association (or relationship) with above-average score on knowledge about HNC (pvalues<0.05).

Conclusion

Majority of the surveyed students were willing to know more about HNC. The use of a properly planned massive school-based HNC education programs may go a long way in educating this population group on HNC.

Tobacco Consumption Among Young Population in Rural Indonesia: Prevalence and Associated Factors

Introduction: Tobacco consumption among youths is increasing in Indonesia and other middle-income countries. In rural areas, its prevalence is even higher compared to urban settings. Understanding the extent and associated factors of tobacco consumption within this population is essential to inform the formulation of appropriate prevention and control strategies. Aims: This study aims at analyzing the prevalence and associated factors of tobacco consumption among the young population living in rural Indonesia. Methods: Data were obtained from Indonesia Family Life Survey wave 5 (IFLS-5). A total of 2,786 responses from respondents aged 15-24 years and living in rural areas were taken into analysis. Binary logistic regression was used to examine the association between tobacco consumption with the predictors. Results: The prevalence of tobacco consumption among youths in rural Indonesia was 26.5%. Binary logistic regression discovered that factors significantly associated with tobacco consumption among young population were aged 20-24 years (AOR = 4.760, 95% CI: 3.557-6.368), less educated (AOR = 5.988, 95% CI: 3.193-11.229), being married (AOR = 2.484, 95% CI: 1.631- 3.782), and having smoking parent (AOR = 1.346, 95% CI: 1.016-1.783). Young males had a much higher tobacco use prevalence (57.1%). Whereas females had significant negative association with tobacco consumption (AOR = 0.001, 95% CI: 0.000-0.002). Conclusion: A large portion of youth in rural Indonesia were identified to have tobacco-use behavior. Appropriate prevention and control strategies are needed to address the population groups identified in this study. Policymakers should anticipate challenges that may occur resulting from geographical and cultural differences. 

Motivators of impulsivity to smoke waterpipe tobacco among Nigerian youth who smoke waterpipe tobacco: the moderating role of social media normalisation of waterpipe tobacco

Background

Impulsivity is a formidable cause of waterpipe tobacco smoking among youth, however, it is understudied among African youth. Using PRIME behavioural theory, this study aimed to develop a model that examines the motivators of impulsivity to smoke waterpipe tobacco in linkage to the moderating role of social media normalisation of waterpipe tobacco, specifically among youth in Nigeria who smoke waterpipe tobacco.

Methods

Data were drawn from 695 respondents who smoke waterpipe tobacco across six Nigerian universities in the South-West zone using the chain-referral sampling procedure. Descriptive analyses of the obtained data were carried out using the Statistical Package for Social Sciences (SPSS) version 25. The constructs in the developed model were validated through Partial Least Squares Structural Equation Modelling (PLS-SEM) in SmartPLS version 3.

Results

Among Nigerian youth who smoke waterpipe tobacco, intention (β = 0.442, P < 0.001) was the strongest motivator of impulsivity to smoke waterpipe tobacco as compared to positive evaluations (β = 0.302, P < 0.001). In addition, social media normalisation of waterpipe tobacco acted as a moderator that strengthened the relationship between intention and impulsivity (β = 0.287, P < 0.01), as well as, between positive evaluations and impulsivity (β = 0.186, P < 0.01) among youth.

Conclusion

Intention greatly instigates Nigerian youth’s impulsivity to smoke waterpipe tobacco, and social media normalisation of waterpipe tobacco also considerably increases their impulsivity to smoke waterpipe tobacco. Youth-focused educational waterpipe tobacco cessation-oriented programmes that utilise diverse constructive-based learning approaches like illustrative learning and counselling, can help to enlighten and encourage Nigerian youth on the importance of shunning the desirability to smoke waterpipe tobacco.

The need for psychosocial oncology research in sub-Saharan Africa: a review of the terrain

Cancer is a major cause of morbidity and mortality in many sub-Saharan African countries, but the field of psycho-oncology is underdeveloped. This article reviews the literature on psychosocial oncology in sub-Saharan African with a view to developing a research and practice agenda in the field. The search engines used were Google Scholar, Psych Info, Web of Science, and PubMed and articles were focused on but not limited to the past 10 years. The search terms were ‘Africa, psycho-oncology, psychosocial oncology, mental health, and cancer’. The review is structured as follows: cancer surveillance in sub-Saharan African, behavioural risk factors, cancer screening, and psychosocial issues related to various types of cancers. Psychological reactions in the context of cancer including adjustment, depression, and anxiety disorders are also discussed. It is suggested that sub-Saharan African countries require appropriate funding to support improved systems of surveillance and implementation of cancer registries. Public health and behavioural interventions are needed to increase the awareness of cervical cancer and preventive health-seeking behaviour among high-risk women. Restrictive laws on opioids need to be reconsidered and behavioural health campaigns to control obesity, limit salt intake, and increase awareness of the risks of ultra-violet light are necessary to reduce the incidence of various cancers. Psychosocial support is necessary to ameliorate depressed mood, anxiety, and anticipation and fear of death among persons living with cancer and their families in sub-Saharan Africa. To this end, the training of practitioners to strengthen psychosocial aspects of care, especially palliative care, is a priority.

Exploration the role of social, cultural and environmental factors in tendency of female adolescents to smoking based on the qualitative content analysis

Background

The aim of this study was to explain the socio-cultural and environmental factors of smoking tendency in female adolescents.

Methods

This qualitative content analysis study was conducted among Iranian female adolescents in Mashhad, Iran. The data was collected through semi-structured interviews with 20 female smokers. The duration of each interview varies from 30 to 70 min. Data collection and management of data were done using MAXQADA software version 10.

Results

In exploration the effective socio-cultural and environmental factors in the tendency of female adolescents to smoking, six subcategories of role modeling of friends, membership in groups, parenting patterns, family modeling, the predisposing community, and the negative impact of the media were extracted.

Conclusions

The results obtained in this study indicated that there is a need to formulate policies and adopt environmental and social laws to reduce smoking. The results also showed the effective role of parents in improving personal skills, creating a stress-free environment in the family, and controlling adolescent behavior. Therefore, it is necessary to pay attention to all social and cultural aspects in order to make the smoking prevention programs.

PREVALENCE AND PREDICTORS OF CIGARETTE SMOKING AND ALCOHOL USE AMONG SECONDARY SCHOOL STUDENTS IN NIGERIA

Background

Cigarette and alcohol use are the most common causes of noncommunicable diseases. Studies related to cigarette and alcohol use among Nigerian adolescents have shown increases in the habits and require urgent intervention. Nationally representative data is needed to develop effective national policies and interventions, but this is lacking. Hence, this study aimed to provide nationally representative empiric information about cigarette and alcohol use prevalence and predictors among Nigerian secondary school students.

Methods

This study included 2,530 Nigerian students in Nigeria from five of the six geopolitical zones in Nigeria. A self-administered questionnaire was used to obtain information about the participants' sociodemographic and school-based characteristics, cigarette and alcohol use status, and harm perception of tobacco and alcohol use. Data were analysed with SPSS version 25 at p<0.05.

Results

Participants' mean age (±SD) was 16.34 (±2.0) years. The prevalences (95%CI) for ever-cigarette and current-cigarette smoking were 11.1% (95%CI:9.9-12.4) and 8.4% (95%CI:7.3-9.5), respectively. While 21.0% (95%CI:19.4-22.7) and 15.6% (14.2-17.1) were the prevalences for lifetime and current alcohol use, respectively. The predictors of current cigarette smoking were studying in northern-Nigeria (aOR:1.94;95%CI:1.10-3.44), attending private-schools (aOR:1.56;95%CI:1.03-2.38), boarding-student (aOR:1.75;95% CI:1.15-2.69), male-gender (aOR:3.03; 95%CI:1.80-5.10), current alcohol use (aOR:12.50;95%CI:8.70-18.18), having no (aOR:2.59;95%CI:1.58-4.26) or low tobacco harm perception (aOR:2.04;95%CI:1.18-3.53). The predictors of current alcohol use were male (aOR:1.32; 95%CI:1.01-1.72) and current cigarette smoking (aOR:12.5;95%CI:8.77-17.86).

Conclusion

The prevalences of cigarette and alcohol use were high among Nigerian secondary school students, and both habits were strongly associated. Their predictors were school-related factors, sociocultural characteristics, and tobacco harm perception.

Health Behavior of Adolescent Smokers During Covid-19 Pandemic

AIM: This research aims to determine the health behavior of adolescent smokers during the COVID-19 pandemic. METHOD: Both quantitative and qualitative analyses were conducted simultaneously using the design of “t” and Chi-square test through the distribution of questionnaires to 135 respondents as well as descriptive design and case studies, respectively. The data were collected by 13 informants through in-depth interviews, observation, and documentation. RESULTS: The results showed that 5 out of the 6 indicators of the demographic characteristics were correlated to the economic pressure of the families of adolescent smokers which also correlates with their health behavior during the COVID-19 pandemic. CONCLUSION: The increase in the price of cigarettes and family control are measures that regulate children from buying cigarettes.

Economic costs of cigarette smoking among adolescents in Nigeria

Background

Cigarette smoking is an established cause of preventable death and often initiated during adolescence. We estimated the short- and long-term costs of cigarette smoking among currently smoking adolescents in Nigeria.

Methods

A cross-sectional survey among adolescents in Oyo state, Nigeria and a review of mortality records of patients managed for lung cancer in a tertiary facility in Ibadan, Nigeria were conducted. Short-term costs estimated were: (a) average weekly costs of purchasing cigarettes by currently smoking adolescents, and (b) costs of managing at least an episode of chronic cough occurring within 12 months of the survey. Long-term costs were limited to: (a) life-time expenditure on purchasing cigarettes, and (b) direct medical and non-medical (transportation) costs of managing lung cancer. Long-term costs were first projected to the approximate year when the adolescents (mean age:16.0 ± 1.8 years) might be diagnosed with lung cancer based on the average age at presentation with symptoms of lung cancer obtained from the records (59.8 years), and then discounted to 2020 prices. This was estimated as 44 years from the base year (2020). Costs were reported in 2020 prices in Nigerian Naira (NGN) and US dollar (USD) equivalent using the Central Bank of Nigeria, June 2020 exchange rate of USD 1: NGN 360.50.

Results

Approximately 3.8% of the adolescents were current cigarette smokers. Average weekly expenditure on cigarettes was NGN 306.82 ± 5.74 (USD 0.85 ± 0.02). About 26% had experienced at least an episode of chronic cough which cost them an average of NGN 1226.81 ± 6.18 (USD 3.40 ± 0.02) to manage. Total future costs of cigarette smoking in 2020 prices for the 43 adolescents who were current smokers in the event that they develop lung cancer were approximately NGN 175.7 million (USD 487.3 thousand), NGN 871.8 million (USD 2.4 million) and NGN 4.6 trillion (USD 12.7 million) at assumed annual inflation rates of 10%, 15%, and 20% respectively and discount rate of 4.25%.

Conclusion

The estimated economic costs of smoking were very high. Efforts to prevent smoking initiation among adolescents in our study area should be intensified. Interventions to subsidize the medical cost of health-related consequences of cigarette smoking are also required, especially as treatment costs are currently largely borne out-of-pocket.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-021-01644-5.

Design and evaluation of psychometric properties of cigarette smoking tendency questionnaire for female adolescents (CTQFA)

Background

The tendency of women to smoke has increased in recent years and the prevalence of smoking among women is increasing. The purpose of this study was to design and evaluation the psychometric properties of the smoking tendency questionnaire for Iranian female adolescents.

Methods

This cross-sectional study was performed on 604 female adolescents in Iran in 2021. The bank of questions was designed based on the qualitative study concepts and review of the literature. To perform the psychometric evaluation, steps such as face validity (qualitative), content validity (qualitative and quantitative) and construct validity (confirmatory factor analysis) were performed. The reliability of the instrument was assessed using McDonald’s omega coefficient and Cronbach’s alpha coefficient.

Results

Based on the results of psychometrics (face, content, and construct validity), the number of questions was reduced from 102 to 52, and 50 questions were removed. Finally, a questionnaire with 52 questions and 5 subscales of the tendency to experience smoking (14 items), re-experience smoking (8 items), cigarette dependence (9 items), intention to quit smoking (9 items), and smoking cessation (12 items) was approved. The content validity ratio (CVR) and content validity index (CVI) for all questions were 0.770 and 0.938, respectively. The Cronbach’s alpha and McDonald’s omega coefficients for all questions were 0.903 and 0.904, respectively.

Conclusion

Based on the results of this questionnaire, 52 questions, and 5 subscales can be used to assess the tendency of female adolescents to cigarette smoking.

A Rapid Review on the Influence of COVID-19 Lockdown and Quarantine Measures on Modifiable Cardiovascular Risk Factors in the General Population

Preceding coronavirus outbreaks resulted in social isolation, which in turn is associated with cardiovascular consequences. Whether the current COVID-19 pandemic negatively impacts cardiovascular health is unclear. The aim of the rapid review was to investigate, whether COVID-19 lockdown influences modifiable cardiovascular risk factors (i.e., physical inactivity, sedentary behaviour, smoking, alcohol use, unhealthy diet, obesity, bad blood lipids, and hypertension) in the general population. Medline and EMBASE were searched until March 2021. Title, abstracts, and full texts were screened by one reviewer and 20% by a second reviewer. Only studies using probability sampling were included in order to ensure the representativeness of the target population. Data extraction and critical appraisal were done by one reviewer and double-checked by another reviewer. We identified 32 studies that fulfilled our inclusion criteria. Findings show that physical activity decreased, and sedentary behaviour increased among all age groups during the COVID-19 lockdown. Among adults, alcohol consumption increased, dietary quality worsened, and the amount of food intake increased. Some adults reported weight gain. Studies on children and adolescents were sparse. This rapid review found a high number of epidemiological studies on the impact of COVID-19 lockdown measures on modifiable cardiovascular risk factors, but only a few used probability sampling methods.

National, regional, and global prevalence of cigarette smoking among women/females in the general population: a systematic review and meta-analysis

Background

This systematic and meta-analysis review aimed to provide an updated estimate of the prevalence of ever and current cigarette smoking in women, in geographic areas worldwide, and demonstrate a trend of the prevalence of smoking over time by using a cumulative meta-analysis.

Methods

Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of ever and current cigarette smoking in women. We searched PubMed, Web of Science (ISI), Scopus, and Ovid from January 2010 to April 2020. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence of ever and current cigarette smoking in women. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression.

Results

The pooled prevalence of ever and current cigarette smoking in women was 28% and 17%, respectively. The pooled prevalence of ever cigarette smoking in adolescent girls/students of the school, adult women, pregnant women, and women with the disease was 23%, 27%, 32%, and 38%, respectively. The pooled prevalence of ever cigarette smoking in the continents of Oceania, Asia, Europe, America, and Africa was 36%, 14%, 38%, 31%, and 32%, respectively.

Conclusions

The prevalence of cigarette smoking among women is very high, which is significant in all subgroups of adolescents, adults, and pregnant women. Therefore, it is necessary to design and implement appropriate educational programs for them, especially in schools, to reduce the side effects and prevalence of smoking among women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12199-020-00924-y.

Beyond Their HIV Status: the Occurrence of Multiple Health Risk Behavior Among Adolescents from a Rural Setting of Sub-Saharan Africa

Background

Health risk behaviors during adolescence may cluster into patterns that might be predicted by specific factors, among which HIV may have an important role.

Method

In a cross-sectional study conducted between 2017 and 2018, clustering of HRB and its associated factors was investigated in rural Kenya among 588 adolescents (36% perinatally HIV infected; 28% perinatally HIV exposed but uninfected; and 36% HIV unexposed/uninfected). Latent class analysis of 22 behaviors followed by multinomial logistic regression were conducted. Four risk behavior classes were identified.

Results

No significant differences were found in behavioral class membership across the three HIV groups (p = 0.366). The risk of membership to the higher risk behavioral classes relative to class 1 (the substance and drug abstinent low risk takers) increased with older adolescent age (p = 0.047), increased among adolescent who experienced mental distress (p < 0.001), and those who felt unsafe in their neighborhood (p < 0.002). Better working memory (p = 0.0037) was found to be protective.

Conclusion

The results highlight a need to include screening and interventions for internalizing mental health problems and deficits in executive functioning, as well as steps to involve family members and communities to address psychosocial risk factors in adolescents in Kenya.

Tobacco use and associated health risk behaviours among university students in 27 countries

Background Evidence of the relationship between tobacco use and multiple health risk behaviours is limited. Objectives The study aimed to investigate the relationship between tobacco use and health risk behaviours in university students across different cultures. Methods In a cross-sectional study the sample included 23,396 university students from 27 countries in Africa, Asia and the Americas. Results Indicate that 5.8 and 5.5% were daily and not daily tobacco users, respectively. In adjusted logistic regression analysis, less than daily and/or daily tobacco use was associated with nutrition and dietary risk behaviour (overweight or obesity, high sodium consumption, rarely or never having breakfast and not avoiding fat and cholesterol), addictive behaviour (binge drinking, drug use, and gambling), sleep risk behaviours (long sleep, poor sleep quality and restless sleep) and other health risk behaviour (having been in a physical fight, inadequate tooth brushing, and multiple sexual partners in the past year). Conclusions Compared to non-tobacco users, less than daily and/or daily tobacco users had significantly higher overweight or obesity, dietary risk behaviour, addictive behaviour, sleep risk behaviours and other health risk behaviour. These associations may be taken into account in health promotion strategies targeting multiple health compromising behaviours.

The burden and risks of pediatric pneumonia in Nigeria: A desk-based review of existing literature and data

BACKGROUND

Pneumonia is a leading killer of children under-5 years, with a high burden in Nigeria. We aimed to quantify the regional burden and risks of pediatric pneumonia in Nigeria, and specifically the states of Lagos and Jigawa.

METHODS

We conducted a scoping literature search for studies of pneumonia morbidity and mortality in under-5 children in Nigeria from 10th December 2018 to 26th April 2019, searching: Cochrane, PubMed, and Web of Science. We included grey literature from stakeholders' websites and information shared by organizations working in Nigeria. We conducted multivariable logistic regression using the 2016 to 2017 Multiple Cluster Indicators Survey data set to explore factors associated with pneumonia. Descriptive analyses of datasets from 2010 to 2019 was done to estimate trends in mortality, morbidity, and vaccination coverage.

RESULTS

We identified 25 relevant papers (10 from Jigawa, 8 from Lagos, and 14 national data). None included data on pneumonia or acute respiratory tract infection burden in the health system, inpatient case-fatality rates, severity, or age-specific pneumonia mortality rates at state level. Secondary data analysis found that no household or caregiver socioeconomic indicators were consistently associated with self-reported symptoms of cough and/or difficulty breathing, and seasonality was inconsistently associated, dependant on region.

CONCLUSION

There is a clear evidence gap around the burden of pediatric pneumonia in Nigeria, and challenges with the interpretation of existing household survey data. Improved survey approaches are needed to understand the risks of pediatric pneumonia in Nigeria, alongside the need for investment in reliable routine data systems to provide data on the clinical pneumonia burden in Nigeria.

Drug Use and High-risk Sexual Behavior among School-Going Adolescents in Nigeria

BACKGROUND: Sexual risk behavior and drug abuse among adolescents and youths remained perpetual topical issues of focus in most developmental programs related to developing countries, especially in Nigeria, where the school-going adolescents constitute more than half of the youths. The high level of teenage pregnancy and sexual violence such as abuses and other harmful trajectories including STIs and HIV is increasingly reported than the pre-2000s. AIM: This study focuses on underscoring the variation in risky sexual behavior among school-going users and non-users of drugs. It also analyzed the predisposing factors of drug use among school-going adolescents in Nigeria. METHODS: In combination with problem behavior theory, the research draws data (n = 11,799) from the 2012 National HIV and AIDS and Reproductive Health Survey (NARHS Plus II) collated by the Federal Ministry of Health in Nigeria with support from the Department for International Development and United States Agency for International Development, to underscore the self-reported sexual risk behavior among students who are users and non-users of drugs. RESULTS: The result revealed that 32.5% (male) and 33.4% (female) use drugs. More than half of the respondents reported that they have engaged in sexual intercourse, 27.3% (male) and 31.8% (female) have had ≥2 lifetime sexual partners. There is higher odds ratio (OR) of risky sexual behavior among students that have ever used drugs or taken alcohol (OR = 2.2, 95% CI [1.8–2.8]) for male and (OR = 2.1, 95% CI [0.83–2.03]) for female. CONCLUSION: The study concludes that continued exposure of school-going youths to drugs or alcohol may pose serious challenge of risky sexual behavior and also severe threat to initiatives on zero new HIV infections or zero new AIDS death in Nigeria. The authors recommend that campaign to discourage drug or alcohol use should be intensified and introduced to all schools.

Predictors of current tobacco smoking by adolescents in Nigeria: Interaction between school location and socioeconomic status

INTRODUCTION

Tobacco smoking is the largest preventable cause of global mortality, with its prevalence increasing in Sub-Saharan Africa, particularly among adolescents. We sought to determine the factors associated with tobacco smoking among Nigerian school adolescents and investigate the interaction between school location and socioeconomic status (SES).

METHODS

Using a cross-sectional study design, 4332 eighth to tenth grade students in rural and urban secondary schools in Enugu State, Nigeria, were selected by stratified two-stage cluster sampling. We collected data using a modified Global Youth Tobacco Survey (GYTS) Core Questionnaire. Outcome measures were current smoking of cigarettes and other smoked tobacco. Multilevel mixed effects logistic regression models were used to determine factors associated with current tobacco smoking and were considered statistically significant at p<0.05.

RESULTS

Prevalences of current smoking of cigarettes and other smoked tobacco were 13.3% (95% CI: 11.3-15.7) and 5.8% (95% CI: 4.6-7.2), respectively. Possession of higher weekly allowance, exposure to secondhand smoke or tobacco advertisements, having smoking parents, friends or classmates who smoke, and sale of cigarettes near school, were positively associated with current smoking of tobacco. Female sex, having both parents employed and being exposed to tobacco teaching in school were negatively associated with current cigarette smoking while increasing age and high father's SES were negatively associated with current smoking of other tobacco products. There was an interaction between school location and father's SES in the association with cigarette smoking. The higher odds of smoking in rural versus urban schools were much higher for students with fathers of high SES compared to low SES. In rural schools, high SES was associated with higher odds of smoking, but in urban schools low SES was associated with higher odds of smoking. CONCLUSIONS Environmental factors are associated with adolescent tobacco smoking. Tobacco control programs should use targeted strategies that vary depending on the local context.

Current prevalence pattern of tobacco smoking in Nigeria: a systematic review and meta-analysis

Background

National smoking cessation strategies in Nigeria are hindered by lack of up-to-date epidemiologic data. We aimed to estimate prevalence of tobacco smoking in Nigeria to guide relevant interventions.

Methods

We conducted systematic search of publicly available evidence from 1990 through 2018. A random-effects meta-analysis and meta-regression epidemiologic model were employed to determine prevalence and number of smokers in Nigeria in 1995 and 2015.

Results

Across 64 studies (n = 54,755), the pooled crude prevalence of current smokers in Nigeria was 10.4% (9.0–11.7) and 17.7% (15.2–20.2) for ever smokers. This was higher among men compared to women in both groups. There was considerable variation across geopolitical zones, ranging from 5.4% (North-west) to 32.1% (North-east) for current smokers, and 10.5% (South-east) to 43.6% (North-east) for ever smokers. Urban and rural dwellers had relatively similar rates of current smokers (10.7 and 9.1%), and ever smokers (18.1 and 17.0%). Estimated median age at initiation of smoking was 16.8 years (IQR: 13.5–18.0). From 1995 to 2015, we estimated an increase in number of current smokers from 8 to 11 million (or a decline from 13 to 10.6% of the population). The pooled mean cigarettes consumption per person per day was 10.1 (6.1–14.2), accounting for 110 million cigarettes per day and over 40 billion cigarettes consumed in Nigeria in 2015.

Conclusions

While the prevalence of smokers may be declining in Nigeria, one out of ten Nigerians still smokes daily. There is need for comprehensive measures and strict anti-tobacco laws targeting tobacco production and marketing.

Outdoor smoking in Nigeria: prevalence, correlates and predictors

BACKGROUND

There is a lack of data on smoking in outdoor-open bars in Nigeria that may translate into effective legislation on public smoking.

METHOD

This study determined the prevalence, demographic and clinical correlates as well as predictors of smoking among a community sample of 1119 patrons of open place bars in Ibadan, Nigeria. Data on current smoking was obtained using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), while smoking intensity was calculated using the Pack-Year. Prevalence of alcohol use was determined using the Alcohol Use Disorders Identification Test (AUDIT), while depression was diagnosed using the Mini International Neuropsychiatry Interview (MINI). Analysis was carried out by SPSS version 20.0 software using Chi square statistics, t test and ANOVA, and was set at 95% confidence interval.

RESULTS

Prevalence of current smoking was 63.8% and the mean pack years of smoking of all respondents was 19.38 ± 17.16 years. Predictors of outdoor smoking were depression OR = 1.41, 95% CI (1.09-1.83) and alcohol use OR = 2.12, 95% CI (1.44-3.13). Predictors of high pack years were depression OR = 1.47, 95% CI (1.08-2.01), being married, OR = 1.78, 95% CI (1.29-2.45), high income, OR = 1.95, 95% CI (1.42-2.68) and alcohol use OR = 2.82, 95% CI (1.51-5.27). There was no significant relationship between stage of readiness to quit smoking and mean pack years of smoking, F = 0.3, p = 0.5.

CONCLUSION

The high prevalence of outdoor smoking in the sample calls for urgent public health initiatives for intervention. Thus, outdoor bars are potential tobacco use intervention sites to minimize the health consequences of smoking.

Potential roles of school administrators and community-residing adults in tobacco use prevention in Nigerian college students: a viewpoint

Tobacco use is a key risk factor for the development of non-communicable diseases such as coronary heart disease, stroke, and peripheral vascular disease. On May 31 every year, World No Tobacco Day is celebrated to draw attention to the health risks and other risks related to tobacco use and to campaign for effective policies to minimize tobacco use. In this paper, we address important issues related to tobacco use, and highlight the potential roles of school administrators and community-residing adults in supporting college students in Nigeria in refraining from tobacco use. We argue that various stakeholders, including school administrators and community-residing adults, have important roles to play in providing community- and school-level support to college students to enable them to refrain from tobacco use. However, research is needed to empirically measure whether and how school administrators and community-residing adults have helped to reduce tobacco use in college students in Nigeria.

Factors Affecting Secondhand Smoke Avoidance Behavior of Vietnamese Adolescents

The purpose of this study was to examine the stage of secondhand smoke avoidance behavior of adolescents in rural areas of Vietnam and the related factors affecting such behavior. The participants were recruited from two middle schools located in Hai Thuong and Trieu Trach commune, Vietnam. Data were collected in January 2016 by distributing and collecting a self-administrated questionnaire. The collected data were analyzed (n = 166) using SPSS 21.0 for frequency, percentage, and ordinal logistic regression. The largest proportion of secondhand smoke avoidance behavior was classified in maintenance (41.6%), followed by action (19.9%), preparation (15.1%), pre-contemplation (13.3%), and contemplation (10.2%) stages. The factors related to higher secondhand smoke avoidance behavior were higher self-efficacy (p = 0.003) and more frequent discussion with parents about dangers of smoking (p = 0.001). The findings indicated that self-efficacy of avoiding secondhand smoke and discussion with parents were associated with secondhand smoke avoidance behavior of adolescents. These findings can be used for developing education programs to prevent secondhand smoke for adolescents in Vietnam.