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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Research article

Disparities in tobacco use by adolescents in southeast, Nigeria using Global Youth Tobacco Survey (GYTS) approach

Authors: Ijeoma U. Itanyi, Chika N. Onwasigwe, Scott McIntosh, Tamara Bruno, Deborah Ossip, Emmanuel A. Nwobi, Chima A. Onoka, Echezona E. Ezeanolue

Published in: BMC Public Health | Issue 1/2018

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Abstract

Background

Tobacco use during adolescence is a substantial problem and adolescents are at higher risk of addiction and prolonged use. To reduce the burden of tobacco-related morbidity and mortality, monitoring of adolescent tobacco use is imperative. We aimed to determine the prevalence of tobacco use among adolescents in urban and rural secondary schools in Enugu State, southeast Nigeria.

Methods

A cross-sectional study of 4332 adolescents in 8th to 10th grades in 25 urban and 24 rural secondary schools in Enugu, Nigeria was done using Global Youth Tobacco Survey (GYTS) methodology. Students were asked about previous and current tobacco use, smoking cessation, and susceptibility to smoking initiation among non-smokers. Geographical, age and sex prevalence differences were examined. Analyses were performed for all adolescents (10–19 years) and for a subset of students, 13–15 years of age for comparison with previous GYTS surveys. All analyses were weighted to account for the complex survey design and for differential non-response at school, class and student levels.

Results

About 28.9% of students reported ever smoking cigarettes; 19.4% reported current tobacco use among all adolescents (13.3, 5.8 and 7.8% for cigarettes, other smoked tobacco, and smokeless tobacco, respectively) while 18.6% reported current tobacco use among 13–15 year olds (12.6, 5.2 and 7.5% for cigarettes, other smoked tobacco and smokeless tobacco respectively). Prevalence of all types of tobacco use was higher in rural schools (vs. urban schools), and among boys (vs. girls). Susceptibility to smoking initiation among non-smokers was 9.3% (95% CI: 8.1–10.7) among all adolescents, and 9% (95% CI: 7.6–10.7) among 13–15 year olds. About 88.1% of all adolescent smokers desired to quit and 57.9% of them had never received help to quit smoking.

Conclusions

Nearly one in every five school-going adolescents currently uses at least one type of tobacco in Enugu State, southeast Nigeria. Prevalence of tobacco use is higher in rural schools and among boys in this setting. Most adolescent current smokers desire to quit and need smoking cessation support.
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Literature
3.
go back to reference Peto R, Lopez AD, Boreham J, Thun M, Heath C Jr. Mortality from smoking in developed countries 1950–2000: indirect estimation from National Vital Statistics. Oxford: Oxford University Press; 1994. Peto R, Lopez AD, Boreham J, Thun M, Heath C Jr. Mortality from smoking in developed countries 1950–2000: indirect estimation from National Vital Statistics. Oxford: Oxford University Press; 1994.
4.
go back to reference Oberg M, Jaakkola MS, Woodward A, Peruga A, Pruss-Ustun A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011;377(9760):139–46. Oberg M, Jaakkola MS, Woodward A, Peruga A, Pruss-Ustun A. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. 2011;377(9760):139–46.
5.
go back to reference Eriksen M, Mackay J, Ross H. The tobacco atlas. 4th ed. USA: American Cancer Society; 2012. Eriksen M, Mackay J, Ross H. The tobacco atlas. 4th ed. USA: American Cancer Society; 2012.
7.
go back to reference Petro R, Lopez AD. Future worldwide health effects of current smoking patterns. In: Koop CE, Pearson CE, Schwarz MR, editors. Critical issues in global health. USA: Wiley (Jossey-Bass); 2001. p. 154–61. Petro R, Lopez AD. Future worldwide health effects of current smoking patterns. In: Koop CE, Pearson CE, Schwarz MR, editors. Critical issues in global health. USA: Wiley (Jossey-Bass); 2001. p. 154–61.
10.
go back to reference Chambers RA, Taylor JR, Potenza MN. Developmental neurocircuitry of motivation in adolescence: a critical period of addiction vulnerability. Am J Psychiatr. 2003;160:1041–52.CrossRefPubMedPubMedCentral Chambers RA, Taylor JR, Potenza MN. Developmental neurocircuitry of motivation in adolescence: a critical period of addiction vulnerability. Am J Psychiatr. 2003;160:1041–52.CrossRefPubMedPubMedCentral
11.
go back to reference Crews F, He J, Hodge C. Adolescent cortical development: a critical period of vulnerability for addiction. Pharmacol Biochem Behav. 2007;86:189–99.CrossRefPubMed Crews F, He J, Hodge C. Adolescent cortical development: a critical period of vulnerability for addiction. Pharmacol Biochem Behav. 2007;86:189–99.CrossRefPubMed
12.
go back to reference Kelder S, Perry C, Klepp KI, Lytle L. Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviours. Am J Public Health. 1994;84(7):1121–6.CrossRefPubMedPubMedCentral Kelder S, Perry C, Klepp KI, Lytle L. Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviours. Am J Public Health. 1994;84(7):1121–6.CrossRefPubMedPubMedCentral
13.
go back to reference Karp I, O'Louglin J, Paradis G, Hanley J, Difranza J. Smoking trajectories of adolescent novice smokers in a longitudinal study of tobacco use. Ann Epidemiology. 2005;15:445–52.CrossRef Karp I, O'Louglin J, Paradis G, Hanley J, Difranza J. Smoking trajectories of adolescent novice smokers in a longitudinal study of tobacco use. Ann Epidemiology. 2005;15:445–52.CrossRef
14.
go back to reference Park S, Weaver TE, Romer D. Predictors of the transition from experimental to daily smoking among adolescents in the United States. J Spec Paediatr Nurs. 2009;14(2):102–11.CrossRef Park S, Weaver TE, Romer D. Predictors of the transition from experimental to daily smoking among adolescents in the United States. J Spec Paediatr Nurs. 2009;14(2):102–11.CrossRef
15.
go back to reference The Global Youth Tobacco Survey Collaborative Group. Tobacco use among youth: a cross-country comparison. Tob Control. 2002;11:252–70.CrossRef The Global Youth Tobacco Survey Collaborative Group. Tobacco use among youth: a cross-country comparison. Tob Control. 2002;11:252–70.CrossRef
16.
go back to reference Warren CW, Jones NR, Eriksen MP, Asma S. Patterns of global tobacco use in young people and implications for future chronic disease burden in adults. Lancet. 2006;367:749–53.CrossRefPubMed Warren CW, Jones NR, Eriksen MP, Asma S. Patterns of global tobacco use in young people and implications for future chronic disease burden in adults. Lancet. 2006;367:749–53.CrossRefPubMed
17.
go back to reference Muula AS, Siziya S, Rudatsikira E. Prevalence and correlates of cigarette smoking among adolescents in Malawi: results from the global youth tobacco survey. Tanzan J Health Res. 2008;10(3):166–76.CrossRefPubMed Muula AS, Siziya S, Rudatsikira E. Prevalence and correlates of cigarette smoking among adolescents in Malawi: results from the global youth tobacco survey. Tanzan J Health Res. 2008;10(3):166–76.CrossRefPubMed
18.
go back to reference Siziya S, Rudatsikira E, Muula AS, Ntata PRT. Predictors of cigarette smoking among adolescents in rural Zambia: results from a cross-sectional study from Chongwe district. Rural Remote Health. 2007;7:728–35.PubMed Siziya S, Rudatsikira E, Muula AS, Ntata PRT. Predictors of cigarette smoking among adolescents in rural Zambia: results from a cross-sectional study from Chongwe district. Rural Remote Health. 2007;7:728–35.PubMed
19.
20.
go back to reference Ekanem IA, Asuzu MC, Anunobi CC, Malami SA, Jibrin PG, Ekanem AD, et al. Prevalence of tobacco use among youths in five centres in Nigeria: a global youth tobacco survey (GYTS) approach. J Comm Med Primary Health Care. 2010;22(1/2):62–7. Ekanem IA, Asuzu MC, Anunobi CC, Malami SA, Jibrin PG, Ekanem AD, et al. Prevalence of tobacco use among youths in five centres in Nigeria: a global youth tobacco survey (GYTS) approach. J Comm Med Primary Health Care. 2010;22(1/2):62–7.
21.
go back to reference Omokhodion FO, Faseru BO. Perception of cigarette smoking and advertisement among senior secondary school students in Ibadan, southwestern Nigeria. West Afr J Med. 2007;26(3):206–9.PubMed Omokhodion FO, Faseru BO. Perception of cigarette smoking and advertisement among senior secondary school students in Ibadan, southwestern Nigeria. West Afr J Med. 2007;26(3):206–9.PubMed
22.
go back to reference Abasiubong F, Atting I, Bassey E, Ekott J. A comparative study of use of psychoactive substances amongst secondary school students in two local government areas of Akwa Ibom state, Nigeria. Niger J Clin Pract. 2008;11(1):45–51.PubMed Abasiubong F, Atting I, Bassey E, Ekott J. A comparative study of use of psychoactive substances amongst secondary school students in two local government areas of Akwa Ibom state, Nigeria. Niger J Clin Pract. 2008;11(1):45–51.PubMed
23.
go back to reference Ekanem IA. Global youth tobacco survey for Nigeria report. 2008. Ekanem IA. Global youth tobacco survey for Nigeria report. 2008.
25.
go back to reference Ibeh CC, Ele PU. Prevalence of cigarette smoking in young Nigerian females. Afr J Med Med Sci. 2003;32(4):335–8.PubMed Ibeh CC, Ele PU. Prevalence of cigarette smoking in young Nigerian females. Afr J Med Med Sci. 2003;32(4):335–8.PubMed
26.
go back to reference Nwafor CC, Ibeh CC, Aguwa EN, Chukwu JN. Assessment of pattern of cigarette smoking and associated factors among male students in public secondary schools in Anambra state, Nigeria. Niger J Med. 2012;21(1):41–7.PubMed Nwafor CC, Ibeh CC, Aguwa EN, Chukwu JN. Assessment of pattern of cigarette smoking and associated factors among male students in public secondary schools in Anambra state, Nigeria. Niger J Med. 2012;21(1):41–7.PubMed
27.
go back to reference Ministry of Education, Enugu State. Enugu state annual school census statistical report, 2013. August, 2013. Ministry of Education, Enugu State. Enugu state annual school census statistical report, 2013. August, 2013.
28.
go back to reference Kirkwood BR, Sterne JAC. Calculation of required sample size. Essential medical statistics. 2nd ed. USA: Blackwell Science Ltd; 2003. p. 413–28. Kirkwood BR, Sterne JAC. Calculation of required sample size. Essential medical statistics. 2nd ed. USA: Blackwell Science Ltd; 2003. p. 413–28.
29.
go back to reference Global Youth Tobacco Survey Collaborative Group. Global youth tobacco survey (GYTS): sample design and weights, version 1.0. Centers for Disease Control and Prevention: Atlanta; 2013. Global Youth Tobacco Survey Collaborative Group. Global youth tobacco survey (GYTS): sample design and weights, version 1.0. Centers for Disease Control and Prevention: Atlanta; 2013.
30.
go back to reference Global Youth Tobacco Survey Collaborative Group. Global youth tobacco survey (GYTS): Core questionnaire with optional questions, version 1.1. 2013 August . Global Youth Tobacco Survey Collaborative Group. Global youth tobacco survey (GYTS): Core questionnaire with optional questions, version 1.1. 2013 August .
33.
go back to reference Kyrlesi A, Soteriades ES, Warren CW, Kremastinou J, Papastergiou P, Jones NR, et al. Tobacco use among students aged 13-15 years in Greece: the global youth tobacco survey project. BMC Public Health. 2007;7:3–8.CrossRefPubMedPubMedCentral Kyrlesi A, Soteriades ES, Warren CW, Kremastinou J, Papastergiou P, Jones NR, et al. Tobacco use among students aged 13-15 years in Greece: the global youth tobacco survey project. BMC Public Health. 2007;7:3–8.CrossRefPubMedPubMedCentral
34.
go back to reference Muula AS, Siziya S. Prevalence and determinants of ever smoked cigarettes among school-going adolescents in Lusaka, Zambia. Afr Health Sci. 2007;7(4):246–52.PubMedPubMedCentral Muula AS, Siziya S. Prevalence and determinants of ever smoked cigarettes among school-going adolescents in Lusaka, Zambia. Afr Health Sci. 2007;7(4):246–52.PubMedPubMedCentral
35.
go back to reference Aslam SK, Zaheer S, Rao S, Shafique K. Prevalence and determinants of susceptibility to cigarette smoking among school students in Pakistan: secondary analysis of global youth tobacco survey. Subst Abuse Treat Prev Policy. 2014;9:10–9.CrossRefPubMedPubMedCentral Aslam SK, Zaheer S, Rao S, Shafique K. Prevalence and determinants of susceptibility to cigarette smoking among school students in Pakistan: secondary analysis of global youth tobacco survey. Subst Abuse Treat Prev Policy. 2014;9:10–9.CrossRefPubMedPubMedCentral
36.
go back to reference Department of Health, Philippines. Global youth tobacco study, Philippines country report. 2011. Department of Health, Philippines. Global youth tobacco study, Philippines country report. 2011.
37.
go back to reference Fatoye FO, Morakinyo O. Substance use amongst secondary school students in rural and urban communities in southwestern Nigeria. East Afr J Med. 2002;79(6):299–305.CrossRef Fatoye FO, Morakinyo O. Substance use amongst secondary school students in rural and urban communities in southwestern Nigeria. East Afr J Med. 2002;79(6):299–305.CrossRef
38.
go back to reference Plotnikoff RC, Bercovitz K, Loucaides CA. Physical activity, smoking and obesity among Canadian school youth: comparison between urban and rural schools. Canadian J Public Health. 2004;95(6):413–8. Plotnikoff RC, Bercovitz K, Loucaides CA. Physical activity, smoking and obesity among Canadian school youth: comparison between urban and rural schools. Canadian J Public Health. 2004;95(6):413–8.
39.
go back to reference Sims TH, Sims M. Tobacco use among adolescents enrolled in Winconsin Medicaid program. WMJ. 2005;104(7):41–6.PubMed Sims TH, Sims M. Tobacco use among adolescents enrolled in Winconsin Medicaid program. WMJ. 2005;104(7):41–6.PubMed
40.
go back to reference Oshodi OY, Aina OF, Onajole AT. Substance use among secondary school students in an urban setting in Nigeria: prevalence and associated factors. Afr J Psychiatry. 2010;13:52–7.CrossRef Oshodi OY, Aina OF, Onajole AT. Substance use among secondary school students in an urban setting in Nigeria: prevalence and associated factors. Afr J Psychiatry. 2010;13:52–7.CrossRef
41.
go back to reference Rudatsikira E, Abdo A, Muula AS. Prevalence and determinants of adolescent tobacco smoking in Addis Ababa, Ethiopia. BMC Public Health. 2007;7:176–81.CrossRefPubMedPubMedCentral Rudatsikira E, Abdo A, Muula AS. Prevalence and determinants of adolescent tobacco smoking in Addis Ababa, Ethiopia. BMC Public Health. 2007;7:176–81.CrossRefPubMedPubMedCentral
42.
go back to reference Reddy KS, Perry CL, Stigler MH, Arora M. Differences in tobacco use among young people in urban India by sex, age, and school grade: assessment of baseline survey data. Lancet. 2006;367(9510):589–94.CrossRefPubMed Reddy KS, Perry CL, Stigler MH, Arora M. Differences in tobacco use among young people in urban India by sex, age, and school grade: assessment of baseline survey data. Lancet. 2006;367(9510):589–94.CrossRefPubMed
43.
go back to reference Baheiraei A, Soltani F, Ebadi A, Cheraghi MA, Rahimi FA. Family and peer risk factors as predictors of lifetime tobacco use among Iranian adolescents: gender similarities and differences. Glob J Health Sci. 2014;6(4):336–54.CrossRef Baheiraei A, Soltani F, Ebadi A, Cheraghi MA, Rahimi FA. Family and peer risk factors as predictors of lifetime tobacco use among Iranian adolescents: gender similarities and differences. Glob J Health Sci. 2014;6(4):336–54.CrossRef
44.
go back to reference Hussian HY, Abdul Satar BA. Prevalence and determinants of tobacco use among Iraqi adolescents: Iraqi global youth tobacco survey 2012. Tob Induc Dis. 2013;11:14–7.CrossRef Hussian HY, Abdul Satar BA. Prevalence and determinants of tobacco use among Iraqi adolescents: Iraqi global youth tobacco survey 2012. Tob Induc Dis. 2013;11:14–7.CrossRef
45.
go back to reference Peltzer K. Smokeless tobacco and cigarette use among black secondary school students in South Africa. Subst Use Misuse. 2003;38:1003–16.CrossRefPubMed Peltzer K. Smokeless tobacco and cigarette use among black secondary school students in South Africa. Subst Use Misuse. 2003;38:1003–16.CrossRefPubMed
46.
go back to reference Idris SH, Sambo MN. Psycho-active substance use among in-school adolescents in Zaria, north western Nigeria: what are the triggers? Niger J Med. 2009;18(3):291–4.PubMed Idris SH, Sambo MN. Psycho-active substance use among in-school adolescents in Zaria, north western Nigeria: what are the triggers? Niger J Med. 2009;18(3):291–4.PubMed
48.
go back to reference National Population Commission (NPC) [Nigeria] and ICF International. Nigeria demographic and health survey 2013. Nigeria and USA: NPC and ICF International; 2014. National Population Commission (NPC) [Nigeria] and ICF International. Nigeria demographic and health survey 2013. Nigeria and USA: NPC and ICF International; 2014.
49.
go back to reference Brener ND, Kann L, McMannus T, Kinchen SA, Sundberg EC, Ross JG. Reliability of the 1999 youth risk behaviour survey questionnaire. J Adolesc Health. 2002;31:336–42. Brener ND, Kann L, McMannus T, Kinchen SA, Sundberg EC, Ross JG. Reliability of the 1999 youth risk behaviour survey questionnaire. J Adolesc Health. 2002;31:336–42.
Metadata
Title
Disparities in tobacco use by adolescents in southeast, Nigeria using Global Youth Tobacco Survey (GYTS) approach
Authors
Ijeoma U. Itanyi
Chika N. Onwasigwe
Scott McIntosh
Tamara Bruno
Deborah Ossip
Emmanuel A. Nwobi
Chima A. Onoka
Echezona E. Ezeanolue
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5231-1

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