Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 26;14(2):e070749.
doi: 10.1136/bmjopen-2022-070749.

Exposure to school-based tobacco prevention interventions in low-income and middle-income countries and its association with psychosocial predictors of smoking among adolescents: a pooled cross-sectional analysis of Global Youth Tobacco Survey data from 38 countries

Onyema Greg Chido-Amajuoyi  1 , Ikponmwosa Osaghae  2   3 , Israel Terungwa Agaku  4 , Baojiang Chen  5 , Dale S Mantey  6
Affiliations

Exposure to school-based tobacco prevention interventions in low-income and middle-income countries and its association with psychosocial predictors of smoking among adolescents: a pooled cross-sectional analysis of Global Youth Tobacco Survey data from 38 countries

Onyema Greg Chido-Amajuoyi et al. BMJ Open. .

Abstract

Objectives: To describe the prevalence of school-based tobacco prevention programme exposure among adolescents in low-income and middle-income countries (LMICs) and its association with psychosocial predictors of smoking.

Design: Analysis of pooled cross-sectional data.

Setting: Global Youth Tobacco Survey (GYTS), conducted in 38 LMICs.

Participants: This was a pooled analysis of data involving a total of 132 755 adolescent respondents to GYTS in 38 LMICs across Africa, Europe and Central/South America between 2014 and 2017.

Exposure and outcome measures: The primary independent variable for this study was self-reported exposure to school-based tobacco prevention programmes in the past year. Five psychosocial determinants of smoking were explored as outcomes: perceived addictiveness of nicotine, perceived harm of secondhand smoke exposure, support for restricting cigarette smoking at public indoor locations, support for restricting cigarette smoking at public outdoor areas and self-reported prediction of enjoying cigarette smoking. Multivariable logistic regression models were used to examine the relationship between exposure to school-based tobacco prevention programmes and study outcomes, controlling for sociodemographic and smoking-related characteristics of respondents.

Results: Overall, 59.1% of adolescents in LMICs self-reported exposure to school-based tobacco prevention programmes. The country-specific prevalence of adolescent exposure to school-based tobacco interventions ranged from 24.9% in the Comoros to 99.3% in Turkmenistan. Exposure to school-based tobacco interventions was significantly associated with greater secondhand smoke harm perceptions (adjusted OR (AOR): 1.69; 95% CI: 1.69 to 1.70), perceptions of addictiveness (AOR: 1.37; 95% CI: 1.36 to 1.37) and supporting tobacco use restrictions indoors (AOR: 1.70; 95% CI: 1.69 to 1.70) and outdoors (AOR: 1.59; 95% CI: 1.59 to 1.60). Exposure to school-based tobacco interventions was associated with lower odds of anticipating enjoying cigarette smoking (AOR: 0.76; 95% CI: 0.76 to 0.76).

Conclusion: Exposure to tobacco prevention programmes in schools is suboptimal in LMICs. Given the protective associations described in this study from school-based tobacco prevention programme exposure, it is imperative that national governments implement school-based programmes into ongoing tobacco control measures.

Keywords: EPIDEMIOLOGY; Health policy; PUBLIC HEALTH.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Tobacco-related knowledge, attitudes and behaviours, stratified by self-reported presence or absence of school-based tobacco prevention programmes among adolescents in 38 countries, 2014–2017.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Forouzanfar MH, Afshin A, Alexander LT, et al. . Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the global burden of disease study 2015. Lancet (British Edition) 2016;388:1659–724. 10.1016/S0140-6736(16)31679-8 - DOI - PMC - PubMed
    1. Gilmore AB, Fooks G, Drope J, et al. . Exposing and addressing tobacco industry conduct in low and middle income countries. Lancet 2015;385:1029–43. 10.1016/S0140-6736(15)60312-9 - DOI - PMC - PubMed
    1. Blecher E. The impact of tobacco advertising bans on consumption in developing countries. J Health Econ 2008;27:930–42. 10.1016/j.jhealeco.2008.02.010 - DOI - PubMed
    1. World Health Organization . Guidelines for implementation of article 13 of the WHO framework convention on tobacco control (Tobacco advertising, promotion and sponsorship). Geneva, Switzerland: World Health Organization, 2008.
    1. Chido-Amajuoyi OG, Fueta P, Mantey D. Age at smoking initiation and prevalence of cigarette use among youths in sub-Saharan Africa, 2014-2017. JAMA Netw Open 2021;4:e218060. 10.1001/jamanetworkopen.2021.8060 - DOI - PMC - PubMed

Substances