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

Investigation of the prevalence and factors influencing tobacco and alcohol use among adolescents in Nigeria: A systematic literature review

The increase in tobacco and alcohol prevalence among Nigerian teenagers necessitates the need to understand the factors influencing use. The aim of this systematic literature review was to synthesis evidence from studies on tobacco and alcohol use among Nigerian adolescents and young adults in order to determine factors influencing tobacco and alcohol use. Six databases MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ScienceDirect, and Google Scholar were used to search for peer-reviewed articles reporting the prevalence and predictors of tobacco and alcohol use among adolescents/youths published between 2010 and 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guided this review. From our search, twelve articles from the 6 geopolitical zones within Nigeria were included. The high prevalence of tobacco and alcohol use among Nigerian adolescents necessitates the need to understand the factors influencing use. A high prevalence rate was recorded among the male gender. Gender, age, and curiosity appear to place adolescents at extra risk for tobacco and alcohol use. Lack of parental monitoring, peer influence, low socio-economic status, low education level, stressful life events, advertisements, availability, and accessibility are factors identified to influence adolescents' alcohol and tobacco use. Alcohol and tobacco use remains a major public health issue as it continues to contribute largely to the growing occurence of diseases globally. Our review showed that adolescents' alcohol and tobacco use behaviour is triggered by various factors on the personal, interpersonal, organisational, community, and policy levels, and these factors are understood to predict or protect against alcohol and tobacco use.

Tobacco use and behaviour among South African adolescents and young adults: systematic review and meta-analysis

OBJECTIVE

Tobacco use, particularly the initiation of smoking during adolescence and young adulthood, represents a significant public health concern in South Africa. This study aims to conduct a comprehensive review of published literature about tobacco use and behaviour among adolescents and young adults and to determine an aggregated prevalence estimate of tobacco use within this demographic.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed/MEDLINE, EMBASE, Cochrane Library, Scopus and Google Scholar were searched from 1 January 2000 through 31 October 2023.

ELIGIBILITY CRITERIA

Studies were eligible for inclusion if they were cross-sectional studies conducted in South Africa and measured the prevalence and determinants of tobacco use among adolescents and young adults aged 12-24 years.

DATA EXTRACTION AND SYNTHESIS

Two reviewers independently extracted information for each article and saved it into an Excel spreadsheet. Risk of bias analysis was conducted using the Risk of Bias Assessment Tool for non-randomised studies. The methodology quality of each selected study was evaluated using the Joanna Briggs Institute checklist. The heterogeneity of prevalence estimates was assessed using I2 statistic (random-effects DerSimonian-Laid approach).

RESULTS

Out of 73 articles identified, 12 articles were included in the analysis. The pooled prevalence of current tobacco use among South African adolescents and young adults was estimated to be 22%. The pooled prevalence of tobacco use among school dropouts, university students and secondary school learners was 51%, 20% and 16%, respectively. Stratifying using gender, boys (26%) were two times more likely to use tobacco than girls (13%).

CONCLUSION

The elevated occurrence of tobacco usage among South African adolescents and young adults is a relevant public health concern. There is a need for more population-based prevalence studies at a national level to estimate the burden of tobacco use in South Africa.

PROSPERO REGISTRATION NUMBER

CRD42023428369.

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.

The prevalence of smoking and the levels of self-esteem and self-efficacy among adolescents in Turkey: A descriptive cross-sectional study

PURPOSE

This study was conducted to determine the prevalence of smoking and the levels of self-esteem and self-efficacy in adolescents and to examine the risk factors affecting smoking.

DESIGN AND METHODS

The present study is a cross-sectional descriptive study. This study was conducted with a total of 2566 adolescents (13-19 years of age). In order to collect research data, Personal Information Form, Rosenberg Self-Esteem Scale, and Self-Efficacy Scale for Children were used.

RESULTS

In the current study, the mean age of adolescents was 15.88 ± 1.20 years and the prevalence of smoking was 11.3%. Variables such as age, gender, family type, parental employment status, presence of smokers in the immediate circle, and self-efficacy levels were determined as risk factors that had an impact on smoking. It was found that the total score of the self-efficacy scale increased the probability of smoking by 3.413 times, the academic self-efficacy subscale by 5.064 times, and the emotional self-efficacy subscale by 2.045 times.

CONCLUSION

The present study concludes that certain adolescents are in the risk group. The adolescents in the risk of smoking are those who have low levels of self-efficacy, who are older, male, have a nuclear family, whose mothers do not work, whose fathers work, and who have smokers in their immediate circle.

PRACTICAL IMPLICATIONS

School nurses can identify students at risk of smoking at an early stage. In addition, training sessions and intervention programs aimed at improving social skills can be developed to boost their self-efficacy.

Prevalence and Associated Factors of Cigarette Smoking among South African Adolescents and Young Adults: A Systematic Review and Meta-Analysis Protocol

Tobacco use, particularly the initiation of smoking during adolescence and young adulthood, represents a significant public health concern in South Africa. The influence of socio-cultural factors, marketing strategies of the tobacco industry, and accessibility of tobacco products have all been implicated in this context. This systematic review and meta-analysis protocol aims to scrutinise the body of literature on this issue, providing a comprehensive understanding of the patterns and determinants of tobacco use among South African adolescents and young adults, with an eye towards informing more effective policy interventions. The available literature for studies on tobacco use will be systematically searched and reviewed. Five international scholarly databases, namely PubMed, MEDLINE, EMBASE, Global Health, and Scopus, will be searched. Peer-reviewed studies will be included if they are conducted in South Africa or South African provinces and if they include the prevalence of tobacco use among adolescents and young adults aged between 12 and 24 years. The results of such an analysis can guide future policy designs, enabling them to be more targeted and thus more effective. The findings can also have implications for shaping global tobacco control strategies, given the transferability of successful interventions across different populations and cultural contexts. This protocol has been registered in the PROSPERO database (ID: CRD42023428369).

Predictors of smoking initiation among Thai adolescents from low-income backgrounds: A case study of Nakhon Pathom low-cost housing estates

INTRODUCTION

Globally, an estimated 1.3 billion people in the world smoke tobacco products, of which more than 8 million die annually. A disproportionate number of these deaths occur in low- and middle-income countries like Thailand. Over 19% (10.7 million) of the Thai population aged ≥15 years were estimated to be smokers; of these, 7.8% were aged 15–18 years. Nearly 1 in 10 Thai students is a current tobacco user; about 20% of these smokers had initiated smoking before their 10th birthday. This shows that early smoking initiation among Thai youths is indeed a public health problem. This study was conducted to examine the factors associated with smoking initiation among adolescents from low-income backgrounds.

METHODS

A cross-sectional study was conducted among youth aged 15–18 years living in low-cost housing estates in Nakhon Pathom province between 1 December 2019 and 30 July 2020. A total of 290 participants were recruited by stratified random sampling. A proprietary questionnaire was used to collect the data, which were analyzed by binary logistic regression.

RESULTS

Risk factors for smoking initiation were having one or both parents deceased (OR=2.28; 95% CI: 1.218–3.471, p=0.001), having divorced parents (OR=1.67; 95% CI: 1.158–2.509, p=0.013), and poor academic performance (OR=2.50; 95% CI: 0.133–3.551, p=0.032). Protective factors were having knowledge of cigarettes (OR=0.65; 95% CI: 0.179–0.895, p=0.004) and correct perception of legal public smoking places (OR=0.45; 95% CI: 0.140–0.850, p=0.025).

CONCLUSIONS

To curb the risks of early smoking initiation among youths of low-income backgrounds, both education and health authorities need to collaboratively design interventions tailored to raise awareness of the negative health impacts of tobacco, improve the performance of underperforming students, and meet the social needs of students whose parents are either deceased or separated to improve their social ties.

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.

Profile and predictors of adolescent tobacco use in Ghana: evidence from the 2017 Global Youth Tobacco Survey (GYTS)

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.

The Negative Impact of Parental Smoking on Adolescents' Health-Promoting Behaviors: A Cross-Sectional Study

The literature has indicated that adolescents’ exposure to secondhand smoke (SHS) and having smoking parents were positively associated with current tobacco smoking. Few studies have explored the association between parental smoking and adolescent’s health-promoting behaviors. This study aimed to examine the prevalence of SHS and the relationship between parental smoking at home and adolescent’s health-promoting behaviors in rural areas. Methods: A school-based and cross-sectional study was conducted from March to December 2019 in western coastal Yunlin County, Taiwan. A total of 1227 adolescents, including 51% boys, anonymously participated in this study. Three parental smoking situations and eight questions of adolescents’ habits extracted from previous studies were applied. A linear regression model was used to analyze the factors associated with adopting health-promoting behaviors. Results: More than half (67.7%) of adolescents experienced parental smoking at home, 90.2% reported their family smoked around them, and 48.8% of participants “sometimes” or “never” avoided SHS. Many participants showed a low frequency of water (49.6%), vegetable (49.1%), and fruit (63.2%) intake, using dental floss (84.7%), and regular exercise (60.6%). The determinants of adolescents’ health-promoting scores were highly associated with avoidance of SHS, less associated with parental smoking, and parents smoking at home and around adolescents. Conclusion: The findings showed that in the rural area, a high prevalence of parental smoking at home and parental smoking around adolescents was noted. It is an important issue that parental smoking was negatively associated with adolescent’s health-promoting behaviors.