Current tobacco use and susceptibility to using tobacco among non-users of tobacco: A cross-sectional study among school-going adolescents in Sierra Leone

INTRODUCTION Tobacco use is a global health threat associated with a high disease burden and death. Current tobacco use and susceptibility to using tobacco products among adolescents who are potential adult tobacco users have not been explored in Sierra Leone. Thus, we aimed to estimate the prevalence and correlates of current tobacco use and tobacco non-users susceptibility to using tobacco amongst high school students in Sierra Leone. METHODS We used data obtained from the 2017 Sierra Leone Global Youth Tobacco Survey (GYTS), which presented information collected from 6680 students aged 11–17 years nationwide. Gender-based correlates of current use and susceptibility to using tobacco among non-tobacco users were determined by complex sample logistic regression analyses. Adjusted odds ratios (AOR) and respective 95% confidence intervals (CIs) are reported. A p<0.05 was considered significant. RESULTS The prevalence of current tobacco use among high school adolescents in Sierra Leone was 24.6%, higher in males (27.9%) than in females (18.6%). Male (AOR=1.50; 95% CI: 1.18–1.91), parental smoking (AOR=1.73; 95% CI: 1.32–2.26) exposure to household secondhand smoke (AOR=1.82; 95% CI: 1.27–2.62), having peers who smoke (AOR=2.24; 95% CI: 1.51–3.31) were more likely to be currently using tobacco. The overall tobacco non-users susceptibility to using tobacco among adolescents in Sierra Leone was 18.2% (males 18.0%, females 18.5%). Exposure to tobacco promotion (AOR=1.50; 95% CI: 1.06–2.10) and non-exposure to anti-smoking education (AOR=1.39; 95% CI: 1.05–1.86) were significantly associated with tobacco non-users’ susceptibility to using tobacco. CONCLUSIONS Our study suggests that one in four school-going adolescents currently uses tobacco, with nearly one in five non-users susceptible to using tobacco. Given the high prevalence of tobacco product use among adults in Sierra Leone, our findings highlight the need for policies and interventions to prevent tobacco use behavior among adolescents, aimed at averting tobacco use in adulthood.

[1]  A. Bah,et al.  Prevalence and correlates of current tobacco use and non-user susceptibility to using tobacco products among school-going adolescents in 22 African countries: a secondary analysis of the 2013-2018 global youth tobacco surveys , 2022, Archives of Public Health.

[2]  S. Witter,et al.  Opportunities and challenges for delivering non-communicable disease management and services in fragile and post-conflict settings: perceptions of policy-makers and health providers in Sierra Leone , 2020, Conflict and Health.

[3]  H. Wurie,et al.  A Scoping Study on Non-Communicable Diseases (NCDs) in Sierra Leone , 2018 .

[4]  T. Langley,et al.  Prevalence and determinants of tobacco use among young people in The Gambia , 2017, BMJ Global Health.

[5]  Katherine E. Masyn,et al.  Multilevel analysis of school anti-smoking education and current cigarette use among South African students , 2017, The Pan African medical journal.

[6]  Nivo Ramanandraibe,et al.  An overview of tobacco control and prevention policy status in Africa. , 2016, Preventive medicine.

[7]  Gretchen A. Stevens,et al.  Global trends and projections for tobacco use, 1990–2025: an analysis of smoking indicators from the WHO Comprehensive Information Systems for Tobacco Control , 2015, The Lancet.

[8]  R. John,et al.  Prevalence and correlates of tobacco use among school-going adolescents in Madagascar , 2015, Journal of epidemiology and global health.

[9]  C. Sreeramareddy,et al.  Prevalence, distribution, and social determinants of tobacco use in 30 sub-Saharan African countries , 2014, BMC Medicine.

[10]  D. O. Atari.  Gender differences in the prevalence and determinants of tobacco use among school-aged adolescents (11 – 17 years) in Sudan and South Sudan , 2014, The Pan African medical journal.

[11]  Shimin Zheng,et al.  Worldwide never-smoking youth susceptibility to smoking. , 2014, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[12]  E. Jassem,et al.  The many faces of tobacco use among women , 2014, Medical science monitor : international medical journal of experimental and clinical research.

[13]  R. John,et al.  Tobacco use among school-going adolescents (11-17 years) in Ghana. , 2013, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[14]  Sang-hee Park.  Smoking and adolescent health , 2011, Korean journal of pediatrics.

[15]  D. Bash-Taqi,et al.  Prevalence of Tobacco Use and Physical Activity among Adult Sierra Leonean Population , 2011 .

[16]  G. Connolly,et al.  Understanding worldwide youth attitudes towards smoke-free policies: an analysis of the Global Youth Tobacco Survey , 2011, Tobacco Control.

[17]  A. Muula,et al.  Current use of smokeless tobacco among adolescents in the Republic of Congo , 2010, BMC public health.

[18]  Samira Asma,et al.  Evolution of the Global Tobacco Surveillance System (GTSS) 1998–2008 , 2009, Global health promotion.

[19]  R. Borland,et al.  Smoking beliefs and behavior among youth in Malaysia and Thailand. , 2009, American journal of health behavior.

[20]  E. Simons.  Patterns of Global Tobacco Use in Young People and Implications for Future Chronic Disease Burden in Adults , 2007 .

[21]  C. Warren,et al.  Patterns of global tobacco use in young people and implications for future chronic disease burden in adults , 2006, The Lancet.

[22]  J. Hollis,et al.  Stages of smoking acquisition versus susceptibility as predictors of smoking initiation in adolescents in primary care. , 2005, Addictive behaviors.

[23]  G. Burci.  World Health Organization (WHO): Framework Convention on Tobacco Control* , 2003, International Legal Materials.

[24]  D. Williams,et al.  Blood pressure and hypertension in rural and urban Sierra Leoneans. , 1999, Ethnicity & disease.

[25]  J. Unger,et al.  Identification of adolescents at risk for smoking initiation: validation of a measure of susceptibility. , 1997, Addictive behaviors.

[26]  E. Gilpin,et al.  Validation of susceptibility as a predictor of which adolescents take up smoking in the United States. , 1996, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[27]  Lisk Rd,et al.  Tobacco and cannabis smoking in secondary school pupils in Bo, Sierra Leone. , 1995 .

[28]  E. Gilpin,et al.  An improved surveillance measure for adolescent smoking? , 1995, Tobacco Control.

[29]  S. Abul Bangura,et al.  Tobacco and cannabis smoking in secondary school pupils in Bo, Sierra Leone. , 1995, West African journal of medicine.