Risk Perception and Correlates of Tobacco Use among Young People Outside of Formal School Settings in Lagos State, Nigeria

  • Odukoya, OO (Department of Community Health and Primary Care, College of Medicine, University of Lagos) ;
  • Dada, MR (Department of Community Health and Primary Care, College of Medicine, University of Lagos) ;
  • Olubodun, T (Department of Community Health, Lagos University Teaching Hospital) ;
  • Igwilo, UA (Department of Community Health, Lagos University Teaching Hospital) ;
  • Ayo-Yusuf, OA (Sefako Makgatho Health Sciences University)
  • Published : 2016.06.01


Background: Tobacco use among youth is a major public health problem. Youth outside of formal school settings are often understudied but may be at increased risk. Materials and Methods: A descriptive cross-sectional study was carried out among 326 young people aged 15-24 years in four randomly selected motor parks in Lagos state. Interviewer-administered questionnaires were used to collect data. Results: The mean age of the respondents was $21.0{\pm}2.3yrs$. Many 252 (77.3%) dropped out before the end of the third year of secondary schooling. The majority were aware that active (78.2%), and passive smoking (77.3%) are harmful to health. Nearly two-thirds of the respondents disagreed with an outright ban of cigarettes (63.2%) and restriction of cigarette sales to persons below 18 years (67.9%) while 254 (66.8%) supported a ban on tobacco smoking in enclosed public places. One hundred and fifty (46.0%) respondents had experimented with smoking of which 106 (32.5%) had progressed to become current smokers. Half of the current smokers, 54 (50.9%), felt the need for a cigarette first thing in the morning. A multivariate analysis for smoking initiation, showed that for every increasing year of age, respondents were 1.08 times more likely to have initiated cigarette smoking; males and respondents who lived alone or with peers were 2.34 times and 1.77 times more likely to have initiated smoking respectively; those who consume alcohol and marijuana were 7.27 and 1.89 times respectively more likely to have initiated smoking while those who consumed alcohol were 6.17 times more likely to be current smokers.


Adolescent smoking;non-formal school settings;risk factors;Lagos;Nigeria


  1. Akindele OA, Babalola F, Adesola OS et al (2010). Substance Abuse Treatment, Prevention, and Policy, 5, 24. https://doi.org/10.1186/1747-597X-5-24
  2. American Cancer Society. (2015) Child and teen tobacco use.
  3. Arrazola RA, Neff LJ, Kennedy SM, et al (2014). Tobacco use among middle and high school students-United States, 2013. MMWR Morb Mortal Wkly Rep, 63, 1021-6.
  4. Ayo-Yusuf OA, Odukoya OO, Olutola BG (2014). Sociodemographic correlates of exclusive and concurrent use of smokeless and smoked tobacco products among Nigerian men. Nicotine Tobacco Res, 16, 641-646. https://doi.org/10.1093/ntr/ntt199
  5. Baker TB, Piper ME, McCarthy DE, et al (2007). Time to first cigarette in the morning as an index of ability to quit smoking: implications for nicotine dependence. Nicotine Tob Res, 9, 555-70. https://doi.org/10.1080/14622200701673480
  6. Center for disease control. Global youth Tobacco Survey(GYTS)-An overview.
  7. Center for Disease Control. Indicator definitions- Tobacco available at http://www.cdc.gov/cdi/definitions/tobacco.html Accessed July 2014
  8. Connecticut Department of Labour: Clarification of the Definition of Outof- School Youth. [http://www.ctdol.state.ct.us/wia/memos/2006/ap06-5.htm], WIA Administration 2006 Memo: AP 06-05. Accessed on 15/7/2010.
  9. DiFranza J (2009). Tobacco dependence in light smokers. Nicotine Tob Res, 11, 1122-3. https://doi.org/10.1093/ntr/ntp130
  10. Duhig AM, Cavallo DA, McKee SA, et al (2005). Daily patterns of alcohol, cigarette, and marijuana use in adolescent smokers and nonsmokers. Addict Behav, 30, 271-83. https://doi.org/10.1016/j.addbeh.2004.05.016
  11. DuRant, RH, Kahn J, Beckford PH, et al (1997). The association of weapon carrying and fighting on school property and other health risk and problem behaviors among high school students. Arch Pediatr Adolesc Med, 151, 360-366. https://doi.org/10.1001/archpedi.1997.02170410034004
  12. Ekanem I (2008). A report for the Nigeria global youth tobacco survey.
  13. Elders MJ, Perry CL, Eriksen MP, et al (1994). The report of the Surgeon General: preventing tobacco use among young people. Am J Public Health, 84, 543-7. https://doi.org/10.2105/AJPH.84.4.543
  14. Embleton L, Mwang A, Vreeman R, et al (2013). The epidemiology of substance use among street children in resource-constrained settings: a systematic review and metaanalysis. Addict, 108, 1722-33. https://doi.org/10.1111/add.12252
  15. Fawibe AE, Shittu AO (2011). Prevalence and characteristics of cigarette smokers among undergraduates of the University of Ilorin, Nigeria. Niger J Clin Pract, 14, 201-205. https://doi.org/10.4103/1119-3077.84016
  16. Global Youth Tobacco Survey Collaborative Group (2002). Tobacco use among youth: a cross country comparison. Tob Control, 11, 252. https://doi.org/10.1136/tc.11.3.252
  17. Hamisu M, Ahmad T, Lim H (2014). Adolescents and drug abuse in Nigeria. J Biol Agriculture Healthcare, 4, 5-9.
  18. Han J, Chen X (2015). A Meta-Analysis of Cigarette Smoking Prevalence among Adolescents in China: 1981-2010. Int J Environ Res Public Health, 12, 4617-30. https://doi.org/10.3390/ijerph120504617
  19. John U, Meyer C, Rumpf HJ, et al (2003). Probabilities of alcohol high-risk drinking, abuse or dependence estimated on grounds of tobacco smoking and nicotine dependence. Addict, 98, 805-14. https://doi.org/10.1046/j.1360-0443.2003.00381.x
  20. Lee YO, Hebert CJ, Nonnemaker JM, et al (2015). Youth Tobacco Product Use in the United States. Pediatrics, 135, 409-15. https://doi.org/10.1542/peds.2014-3202
  21. Lewinsohn PM, Rohde P, Brown RA (1999). Level of current and past adolescent cigarette smoking as predictors of future substance use disorders in young adulthood. Addiction, 94, 913-921 https://doi.org/10.1046/j.1360-0443.1999.94691313.x
  22. Mamudu HM, Veeranki SP, John RM (2013). Tobacco use among school-going adolescents (11-17 years) in Ghana. Nicotine Tob Res, 15, 1355-64. https://doi.org/10.1093/ntr/nts269
  23. Mpabulungi L, Muula AS (2004). Tobacco use among high school students in Kampala, Uganda: questionnaire study. Croat Med J, 45, 80-3.
  24. Muula AS, Siziya S, Rudatsikira E (2008). Prevalence and correlates of cigarette smoking among adolescents in Malawi: results from the Global Youth Tobacco Survey 2005. Tanzan J Health Res, 10, 166-176.
  25. National Institute on drug abuse publication available at http://www.drugabuse.gov/publications/research-reports/tobacco/smoking-adolescence. Accessed 20/07/15
  26. National Population Commission Nigeria (2009). Nigeria Demographic and Health Survey 2008. Available at http://dhsprogram.com/pubs/pdf/fr222/fr222.pdf Accessed October 2015.
  27. Nwafor CC, Ibeh CC, Aguwa EN, et al (2012). Assessment of pattern of cigarette smoking and associated factors among male students in public secondary schools in Anambra State, Nigeria. Niger J Med, 21, 41-7.
  28. Odukoya OO, Odeyemi KA, Oyeyemi AS, et al (2013). Determinants of smoking initiation and susceptibility to future smoking among school-going adolescents in Lagos state, Nigeria. Asian Pac J Cancer Prev, 14, 1747-53 https://doi.org/10.7314/APJCP.2013.14.3.1747
  29. Okagua J, Opara P, Alex-Hart BA (2015). Prevalence and determinants of cigarette smoking among adolescents in secondary schools in Port Harcourt, Southern Nigeria. Int J Adolesc Med Health, 28, 19-24
  30. Richter KP, Ahluwalia HK, Mosier MC, et al (2002). A population-based study of cigarette smoking among illicit drug users in the United States. Addict, 97, 861-9. https://doi.org/10.1046/j.1360-0443.2002.00162.x
  31. Salawu F, Danburam A, Isa B, et al (2010). Cigarette smoking habits among adolescents in northeast Nigeria. Internet J Epidemiol, 8.
  32. Simantov E, Schoen C, Klein JD (2000). Health - compromising behaviours: why do adolescents smoke or drink. Arch Pediatr Adolesc Med, 154, 1025-33. https://doi.org/10.1001/archpedi.154.10.1025
  33. Substance Abuse and Mental Health Services Administration, HHS (2014). Results from the 2013 National Survey on Drug Use and Health, NSDUH: Summary of National Findings.
  34. The Federal Ministry of Education, Nigeria (2006). National School health policy.
  35. The World Bank (2015). Education. Available at http://www.worldbank.org/en/topic/education. Accessed October 2015.
  36. Tucker JS, Shadel WG, Golinelli D, et al (2014). Alternative tobacco product use and smoking cessation among homeless youth in Los Angeles County. Nicotine Tob Res, 16, 1522-1526. https://doi.org/10.1093/ntr/ntu133
  37. Tucker JS, Shadel WG, Golinelli D, et al (2015). Sniping and other high-risk smoking practices among homeless youth. Drug Alcohol Depend, 154, 105-10. https://doi.org/10.1016/j.drugalcdep.2015.06.036
  38. Twyman L, Bonevski B, Paul C, et al (2014). Perceived barriers to smoking cessation in selected vulnerable groups: a systematic review of the qualitative and quantitative literature. BMJ Open, 4, 6414.
  39. UNICEF (2015). Sustainable development starts and ends with safe, healthy and well- educated children. United Nations. Defintions of youth. Available at http://www.un.org/esa/socdev/documents/youth/fact-sheets/youthdefinition.pdf Accessed July 2015.
  40. United States Center for Disease control (2015). Preventing Tobacco Use Among Young People-A Report of the Surgeon General,1994.
  41. Warren CW, Jones NR, Peruga A, et al (2008). Global Youth Tobacco Surveillance, 2000--2007. MMWR, 57, 1-21
  42. World Health Organisation Tobacco Free Initiative (2004). Tobacco and poverty: a vicious circle.
  43. World Health Organization (2015). Tobacco factsheet. Available at http://www.who.int/mediacentre/factsheets/fs339/en/. Accessed May 2015.
  44. World Health Organization (2013). Tobacco free initiative, Global Youth Tobacco Survey.