Tobacco use: the main predictor of illicit substances use among young adolescents in Sousse, Tunisia

Prevalence and predictors of tobacco, alcohol and illicit drug experimentation among Tunisian middle and high school-adolescents

OBJECTIVES

Psychoactive substance experimentation among Tunisian adolescents remains one of the most threatening public health concerns. In spite of this, little is known about the prevalence and predictors of these behaviors in the Tunisian context. This study aims to assess the prevalence of tobacco, alcohol and illicit drug experimentation and its predictive factors among adolescents in the delegation of Nfidha, Sousse governorate, Tunisia.

METHODS

We conducted a cross sectional study in middle and high schools in the delegation of Nfidha, Sousse governorate, Tunisia, during the first trimester of the 2019-2020 school year using an anonymous questionnaire self-administered to a randomly drawn representative sample of 1,352 pupils. Data collected included socio-demographic characteristics, substance experimentation among school-adolescents, academic performance as well as family and peer' factors.

RESULTS

Tobacco was the most commonly experimented substance with a prevalence rate of 17.5 % (CI 95 %: 14.8-18.8 %). The prevalence of alcohol and illicit drugs use were 3.3 % [CI 95 %: (2.1-3.9 %)] and 2 % [CI 95 %: (1.1-2.6 %)] respectively. Being male (Adjusted (AOR)=4.09, p<0.001), being a high school pupil (AOR=2.81, p<0.001), having experiencing academic failure (AOR=1.60, p=0.007) and having a father and siblings who use tobacco (AOR=1.72, p=0.002; AOR=2.03, p=0.001 respectively) were the predictors of tobacco experimentation in the multivariate logistic regression analysis. Additionally, being male (AOR=8.40, p<0.001), having experienced academic failure (AOR=2.76, p=0.017) as well as having a father and siblings who use alcohol (AOR=5.90, p<0.001; AOR=3.03, p=0.045 respectively) and having experienced tobacco (AOR=4.28, p<0.001) were the determinants of alcohol experimentation. Similarly, having a history of academic failure (AOR=3.44, p=0.041), having peers who use illicit drugs (AOR=3.22, p=0.028), having a history of tobacco and alcohol experimentation (AOR=6.52, p<0.001; AOR=3.49, p=0.046 respectively) were the predictors of illicit drug experimentation among adolescents.

CONCLUSIONS

A substantial number of socio-demographic and environmental factors have been identified as being involved in experimentation with psychoactive substance during adolescence. Therefore, further prevention programs targeting not only adolescents, but also all risk factors are needed.

Tobacco Use and Its Association with Mental Morbidity and Health Compromising Behaviours in Adolescents in Indonesia

Background:

Limited evidence has been established on associations between tobacco use and mental morbidity and health compromising behaviours. The study aimed to investigate the associations between tobacco use, mental problems, and health risk behaviour among adolescents attending school in Indonesia. Methods: Nationally representative data were studied from 11,124 adolescents that took part in the cross-sectional “Indonesia Global School-Based Student Health Survey (GSHS) in 2015”.

Results:

The prevalence of current tobacco use was 12.8%. In adjusted logistic regression analysis, compared to non-current or never tobacco users, current tobacco use was associated with eight of eight mental problem indicators (lonely, anxiety, no close friend, suicidal ideation, suicide plan, suicide attempt and current alcohol use), two of four dietary risk behaviours (soft drink and fast food consumption) and seven of ten other health risk behaviours (in a physical fight, bullied, injury, ever sex, school truancy, and two sub-optimal hand hygiene behaviours).

Conclusion:

Compared to nontobacco users, current tobacco users had significantly higher mental problem indicators and health risk behaviours. Multiple comorbidity with tobacco use should be targeted in interventions.

Tobacco use and associated mental symptoms and health risk behaviours amongst individuals 15 years or older in South Africa

Background

Tobacco use may deteriorate mental health and increase health risk behaviours.

Aim

The aim of this investigation was to identify associations between tobacco use and mental illness symptoms and health risk behaviours in individuals 15 years or older in South Africa.

Setting

Community-based national population sample in South Africa.

Methods

Cross-sectional data were analysed from the 'South African National Health and Nutrition Examination Survey (SANHANES-1) 2012', using a sample of 15 310 individuals 15 years or older (median age 33 years). Measures included information on tobacco use, sociodemographic factors, mental symptoms and health risk behaviour.

Results

Compared to non-tobacco users, daily tobacco users were associated with psychological distress and post-traumatic stress disorder (PTSD) in adjusted logistic regression analysis, and with sleeping problems in unadjusted analysis. Past tobacco use, less than daily, and daily tobacco use were highly associated with a drinking problem. In terms of dietary variables, less than daily and daily tobacco use increased the odds of inadequate fruit intake and salty food intake, and daily tobacco use decreased the odds of fast food consumption. Past tobacco use, less than daily, and daily tobacco use were inversely associated with physical inactivity, and daily tobacco use was associated with not always washing hands before eating.

Conclusions

The study showed that compared to non-tobacco users, daily tobacco users had significantly poorer mental health (psychological distress and PTSD) and increased odds for several health risk behaviours (drinking problem, inadequate fruit intake, salty food consumption and not always washing hands before eating) as compared to non-tobacco users.

Prevalence and factors associated with smoking among Tunisian secondary school-adolescents

OBJECTIVES

This study aimed to estimate the extent of smoking experience among high and middle school adolescents in Southern Tunisia and to delineate its potential associated factors.

METHODS

We conducted a cross-sectional study among middle and high school-adolescents in the governorate of Sfax, South of Tunisia in the 2017-2018 school-years. A questionnaire was anonymously administered to a representative sample of 1,210 school-adolescents randomly drawn.

RESULTS

The mean age of the school-adolescents was 15.6 ± 4.2 years. The prevalence of lifetime smoking was 16.7% (95% CI=[14.7-18.8%]) (boys 32.6%; girls 5.9%;p<0.001). Among the respondents, 13.9% (95% CI=[11.9-15.8%]) were current smokers. In multivariate logistic regression analysis, independent associated factors of current smoking were male gender (Adjusted (AOR)=10.2; p<0.001), 16-17 and 18-19-year age-groups (AOR=2; p=0.005 and AOR=2.6; p=0.001, respectively), below average academic performance (AOR=5.2; p=0.012), divorced parents (AOR=3.9; p=0.007), family monthly income ≥800 dollars (AOR=2.1; p=0.001), having a part time job (AOR=3.9; p<0.001) and a perceived high stress level (AOR=1.98; p=0.008). Secondhand smoke (AOR=1.8; p=0.011) and concomitant alcohol drink (AOR=14.56; p<0.001) were independent predictors of current smoking, while high education level of the father was independently associated with lower prevalence of current smoking (AOR=0.17; p<0.001).

CONCLUSION

The prevalence of lifetime and current smoking were relatively high in Southern Tunisian middle and high schools. Multilevel influences on youth smoking behavior had been identified, which reflected the need to conceive appropriate school interventions and effective antismoking education program.

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.