Predictors of Smoked and Smokeless Tobacco among Adolescents in Ibadan, Nigeria 2021

  • Cancer
  • Cardiovascular Diseases
  • Environmental Health (Including Water & Sanitation)
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Accounting for 8 million deaths annually, most tobacco use starts by adolescence causing dependence and prolonged use. Adolescent tobacco use monitoring is critical to tobacco control. We therefore assessed the prevalence and predictors of tobacco use amongst adolescents in Ibadan, Nigeria.

We conducted a cross-sectional study using a two-stage cluster design to select 3199 students from 23 schools. We adapted the Global Youth Tobacco Survey Core Questionnaire Version 1.2 for data collection. Key variables were tobacco use, exposure to second-hand smoke (SHS) and tobacco advertising. We modeled logistic regression for current smoked tobacco (ST) and smokeless tobacco (SLT) use. We weighted all analyses for complex survey design and differential non-response at school, class, and student levels.

Current use of ST and SLT were reported by 1.8% (95% CI: 1.1-3.0) and 1.1% (95% CI: 0.6-1.9) of respondents respectively. Among all respondents, 46.1% (95% CI: 42.3-49.9) were exposed to SHS, and 51.3% (95% CI: 47.4-55.3) noticed tobacco use on television/videos/movies. Predictors of current ST use were smoking friends (aOR=2.49; 95% CI: 1.12-5.53), cigarette access (aOR=9.94; 95% CI: 2.77- 35.69), current SLT use (aOR=110.70; 95% CI: 25.38-482.88), and exposure to free tobacco promotion (aOR=1.68; 95% CI: 1.01-2.79). Predictors of current SLT use were males (aOR=18.27; 95% CI: 3.14-106.44), employed mother/female guardian (aOR=5.81; 95% CI: 1.21-27.77), perceived safety of short-term smoking (aOR=7.15; 95% CI: 1.66-30.87), and current smoked tobacco use (aOR=138.85; 95% CI: 13.81-1395.60).

Tobacco use was low but with significant exposure to SHS and pro-tobacco advertising. Predictors of current use of both tobacco types included peer influence, cigarette access, tobacco use misperceptions, pro-tobacco advertising and simultaneous use of other tobacco type. We recommended an integrated approach towards control of ST and
SLT, anti-tobacco campaign using a peer education strategy, and enforcement of comprehensive bans on pro-tobacco advertising and public smoking.

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