- Volume 14 Issue 3
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Determinants of Smoking Initiation and Susceptibility to Future Smoking among School-Going Adolescents in Lagos State, Nigeria
- Odukoya, Oluwakemi Ololade ;
- Odeyemi, Kofoworola Abimbola ;
- Oyeyemi, Abisoye Sunday ;
- Upadhyay, Ravi Prakash
- Published : 2013.03.30
Background: It is projected that low and middle-income countries will bear a major burden of tobacco related morbidity and mortality, yet, only limited information is available on the determinants of smoking initiation among youth in Africa. This study aimed to assess the determinants of smoking initiation and susceptibility to future smoking among a population of high school school students in Lagos, Nigeria. Materials and Methods: Baseline data from an intervention study designed to assess the effect of an anti-smoking awareness program on the knowledge, attitudes and practices of adolescents was analyzed. The survey was carried out in six randomly selected public and private secondary schools in local government areas in Lagos state, Nigeria. A total of 973 students completed self-administered questionnaires on smoking initiation, health related knowledge and attitudes towards smoking, susceptibility to future smoking and other factors associated with smoking. Results: Of the respondents, 9.7% had initiated smoking tobacco products with the predominant form being cigarettes (7.3%). Males (OR: 2.77, 95%CI: 1.65-4.66) and those with more pro-smoking attitudes (OR: 1.44, 95%CI: 1.34-1.54) were more likely to have initiated smoking. Those with parents and friends who are smokers were 3.47 (95%CI: 1.50-8.05) and 2.26 (95%CI: 1.27-4.01) times more likely to have initiated smoking. Non-smoking students, in privately owned schools (OR: 5.08), with friends who smoke (5.09), with lower knowledge (OR: 0.87) and more pro-smoking attitudes (OR 1.13) were more susceptible to future smoking. In addition, respondents who had been sent to purchase cigarettes by an older adult (OR: 3.68) were also more susceptible to future smoking. Conclusions: Being male and having parents who smoke are predictors of smoking initiation among these students. Consistent with findings in other countries, peers not only influence smoking initiation but also influence smoking susceptibility among youth in this African setting. Prevention programs designed to reduce tobacco use among in-school youth should take these factors into consideration. In line with the recommendations of article 16 of the WHO FCTC, efforts to enforce the ban on the sales of cigarettes to minors should be also emphasised.
Tobacco smoking;adolescents;susceptibility;Lagos State;Nigeria
- American Cancer Society. Cancer facts and figures (2005). Available at: http://our.cancer.org/downloads/STT/CAFF2005f4PWSecured.pdf.
- American Cancer Society. (2003) Why the FDA should regulate tobacco products. Available at:http://www.tobaccofreekids.org/research/factsheets/pdf/0187.pdf.
- Arora M, Stigler M, Gupta V, et al (2010). Tobacco control among disadvantaged youth living in low income communities in India: introducing project ACTIVITY. Asian Pac J Cancer Prev, 11, 45-52.
- Breslau N, Peterson EL (1996). Smoking cessation in young adults: age at initiation of cigarette smoking and other suspected influences. Am J Public Health, 86, 214-20. https://doi.org/10.2105/AJPH.86.2.214
- Cannon G, Gupta P, Gomes F, et al (2012). Prevention of cancer and non-communicable diseases. Asian Pac J Cancer Prev, 13, 3-11
- Centre for Disease Control and Prevention (2008) Available at http://apps.nccd.cdc.gov/gtssdata/Ancillary/Documentation.aspx?SUID=1&DOCT=1.
- Centre for Disease Control and Prevention.(2012) Youth and tobacco use. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm.
- Chassin L, Presson CC, Sherman SJ (1990). The natural history of cigarette smoking: predicting young-adult smoking outcomes from adolescent smoking patterns. Health Psychol, 9, 701-16. https://doi.org/10.1037/0278-6184.108.40.2061
- Coambs RS, Seline L, Kozlowski LT (1992). Age interacts with heaviness of smoking in predicting success in cessation of smoking. Am J Epidemiol, 135, 240-6.
- Delorme DE, Kreshel PJ, Reid LN (2003). Lighting up: young adults' autobiographical accounts of their first smoking experiences. Youth and Society, 34, 468-96. https://doi.org/10.1177/0044118X03034004004
- Dhavan P, Stigler M, Perry C, et al (2009). Patterns of tobacco use and psychosocial risk factors among students in 6th through 10th grades in India: 2004-2006. Asian Pac J Cancer Prev, 10, 807-13
- Ekanem I (2008). A report for the Nigeria global youth tobacco survey. Available at:http://www.afro.who.int/dnc/databases/gyts/reports/NIGERIA_GYTS%202008.pdf.
- El Ansari W, Labeeb S, Kotb S, et al (2012). Correlates of smoking, quit attempts and attitudes towards total smoking Bans at University: Findings from Eleven Faculties in Egypt. Asian Pac J Cancer Prev, 13, 2547-56. https://doi.org/10.7314/APJCP.2012.13.6.2547
- Flay BR, Hu FB, Siddiqui O, et al (1994). Differential influence of parental smoking and friends' smoking on adolescent initiation and escalation and smoking. J Health and Social Behavior, 35, 248-65 https://doi.org/10.2307/2137279
- Gajalakshmi V, Asma S, Warren C, et al (2004). Tobacco survey among youth in South India. Asian Pac J Cancer Prev, 5, 273-8.
- Gilman SE, Rende R, Boergers J, et al (2009). Parental smoking and adolescent smoking initiation: an intergenerational perspective on tobacco control. Pediatrics, 123, 274-81. https://doi.org/10.1542/peds.2008-2251
- Leatherdale ST, Manske S. (2005). The relationship between student smoking in the school environment and smoking onset in elementary school students. Cancer Epidemiol Biomarkers and Prev, 14, 1762-5. https://doi.org/10.1158/1055-9965.EPI-05-0065
- Mackay J, Eriksen M (2002). The tobacco atlas. Available at http://www.who.int/tobacco/en/atas4.pdf.
- Maxwell KA (2002). Friends: the role of peer influence across adolescent risk behaviors. J Youth and Adolescence, 31, 267-77. https://doi.org/10.1023/A:1015493316865
- Muttappallymyalil J, Divakaran B, Thomas T, et al (2012). Prevalence of tobacco use among adolescents in India. Asian Pac J Cancer Prev, 13, 5371-4. https://doi.org/10.7314/APJCP.2012.13.11.5371
- National Population Commission, Federal Republic of Nigeria. (2009) Nigeria demographic and health survey. November 2009 Available at: http://www.measuredhs.com/pubs/pdf/FR222/FR222.pdf.
- Oshodi OY, Aina OF, Onajole AT (2010). Substance use among secondary school students in an urban setting in Nigeria:prevalence and associated factors. Afr J Psychiatry, 13, 1.
- Osibogun A, Odeyemi K, Akinsete A, et al (2009).The prevalence and predictors of cigarette smoking among secondary school students in Nigeria. Niger Postgrad Med J, 16, 40-5.
- Osungbade KO, Oshiname FO (2008). The determinants of cigarette smoking among senior secondary students in a rural community in South Western Nigeria. Niger J Med, 17, 40-4.
- Pierce JP, Gilpin E (1996). How long will today's new adolescent smoker be addicted to cigarettes? Am J Public Health, 86, 253-6. https://doi.org/10.2105/AJPH.86.2.253
- Population Reference Bureau (2009). Nigeria-summary. November 2009; Available at: http://www.prb.org/Datafinder/Geography/Summary.aspx?region=29&resion_type=2.
- Raute LJ, Sansone G, Pednekar MS, et al (2011). Knowledge of health effects and intentions to quit among smokeless tobacco users in India: findings from the international tobacco control policy evaluation (ITC) India pilot survey. Asian Pac J Cancer Prev, 12, 1233-8.
- Sari D, Pektas I, Baykal Z, et al (2011). Cigarette dependence among males and females aged 50+ living in İzmir, Turkey. Asian Pac J Cancer Prev, 12, 1813-5.
- Sen U, Basu A (2000). Factors influencing smoking behavior among adolescents. Asian Pac J Cancer Prev, 1, 305-9.
- Sinha DN, Gupta P, Gangadharan P (2007). Tobacco use among students and school personnel in India. Asian Pac J Cancer Prev, 8, 417-21.
- The World Bank (2012). Nigeria country at a glance. Available at http://www.worldbank.org/en/country/nigeria.
- Turner L, Memelstein R, Flay B (2004). Individual and contextual influences on adolescent smoking. Ann NY Acad Sci, 1621, 175-97.
- Tyas SL, Pederson LL (1998). Psychosocial factors related to adolescent smoking: a critical review of the literature. Tob Control, 7, 409-20. https://doi.org/10.1136/tc.7.4.409
- US Department of Health and Human Services (1994). Preventing tobacco use among young people. A report of the Surgeon General, Atlanta, Georgia: Public Health Service, Centers for Disease Control and Prevention,Office on Smoking and Health, 1994. (US Government Printing Office Publication No S/N 017-001-00491-0.).
- US Department of Health and Human Services (2004). The health consequences of smoking: a report of the surgeon general. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health.
- US Department of Health and Human Services (2005). Public Health Service, National Toxicology Program. Report on Carcinogens. Eleventh Edition. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Office on Smoking and Health.
- US Department of Health and Human Services (2010). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
- Washio M, Kiyohara C, Morioka M, et al (2003). The Experiences of Smoking in School Children up to and including High School Ages and the Current Status of Smoking Habits; a Survey of Male High School Students in Japan. Asian Pac J Cancer Prev, 4, 344-51.
- World Health Organization (2000). Ghana global youth tobacco survey. Accessed 2009 June; available at: http://www.afro.who.int/dnc/databases/gyts/Ghana/Ghana%20GYTS%20Factsheet%202000.pdf
- World Health Organization (2001). Malawi-Blantyre global youth tobacco survey 2001. Accessed 2009 June; available at http://www.afro.who.int/dnc/databases/gyts/Malawi/Malawi%20Blantyre%202001%20Factsheet.pdf
- World Health Organization (2011). Tobacco free initiative. About youth and tobacco. Available at http://www.who.int/tobacco/research/youth/about/en/index.html accessed January 2013.
- World Health Organistion (2012). Tobacco fact sheet. Available at http://www.who.int/mediacentre/factsheets/fs339/en/index.html.
- Yisa IO, Lawoyin TO, Fatiregun AA, et al (2009) Pattern of substance use among senior students of command secondary schools in Ibadan, Nigeria. Niger J Med, 18, 286-90.
- Smoking Prevention for Adolescents in Romanian Schools vol.14, pp.11, 2013, https://doi.org/10.7314/APJCP.2013.14.11.7017
- Evaluation of a Specially Designed Tobacco Control Program to Reduce Tobacco Use among School Children in Kerala vol.14, pp.6, 2013, https://doi.org/10.7314/APJCP.2013.14.6.3455
- Analysis of Motivating Factors for Smokeless Tobacco Use in Two Indian States vol.15, pp.16, 2014, https://doi.org/10.7314/APJCP.2014.15.16.6553
- Modification of a Smoking Motivation Questionnaire for Chinese Medical Students vol.15, pp.6, 2014, https://doi.org/10.7314/APJCP.2014.15.6.2707
- Common Misconceptions and Future Intention to Smoke among Secondary School Students in Malaysia vol.16, pp.3, 2015, https://doi.org/10.7314/APJCP.2015.16.3.1159
- Perceived effectiveness of graphic health warnings as a deterrent for smoking initiation among adolescents in selected schools in southwest Nigeria vol.14, pp.1, 2016, https://doi.org/10.1186/s12971-016-0074-y
- Age of initiation, Determinants and Prevalence of Cigarette Smoking among Teenagers in Mushin Local Government Area of Lagos State, Nigeria vol.17, pp.3, 2016, https://doi.org/10.7314/APJCP.2016.17.3.1209
- Age of smoking initiation among adolescents in Africa vol.62, pp.1, 2017, https://doi.org/10.1007/s00038-016-0888-7
- The smoking spectrum: review of the existing evidence and future directions pp.1613-2238, 2019, https://doi.org/10.1007/s10389-018-01009-5