Itanyi Ijeoma U, Onwasigwe Chika N, Ossip Deborah, Uzochukwu Benjamin S C, McIntosh Scott, Aguwa Emmanuel N, Wang Sijiu, Onoka Chima A, Ezeanolue Echezona E
Department of Community Medicine, University of Nigeria, Enugu, Nigeria.
Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Tob Induc Dis. 2020 Mar 3;18:13. doi: 10.18332/tid/117959. eCollection 2020.
Tobacco smoking is the largest preventable cause of global mortality, with its prevalence increasing in Sub-Saharan Africa, particularly among adolescents. We sought to determine the factors associated with tobacco smoking among Nigerian school adolescents and investigate the interaction between school location and socioeconomic status (SES).
Using a cross-sectional study design, 4332 eighth to tenth grade students in rural and urban secondary schools in Enugu State, Nigeria, were selected by stratified two-stage cluster sampling. We collected data using a modified Global Youth Tobacco Survey (GYTS) Core Questionnaire. Outcome measures were current smoking of cigarettes and other smoked tobacco. Multilevel mixed effects logistic regression models were used to determine factors associated with current tobacco smoking and were considered statistically significant at p<0.05.
Prevalences of current smoking of cigarettes and other smoked tobacco were 13.3% (95% CI: 11.3-15.7) and 5.8% (95% CI: 4.6-7.2), respectively. Possession of higher weekly allowance, exposure to secondhand smoke or tobacco advertisements, having smoking parents, friends or classmates who smoke, and sale of cigarettes near school, were positively associated with current smoking of tobacco. Female sex, having both parents employed and being exposed to tobacco teaching in school were negatively associated with current cigarette smoking while increasing age and high father's SES were negatively associated with current smoking of other tobacco products. There was an interaction between school location and father's SES in the association with cigarette smoking. The higher odds of smoking in rural versus urban schools were much higher for students with fathers of high SES compared to low SES. In rural schools, high SES was associated with higher odds of smoking, but in urban schools low SES was associated with higher odds of smoking. Environmental factors are associated with adolescent tobacco smoking. Tobacco control programs should use targeted strategies that vary depending on the local context.
吸烟是全球可预防死亡的最大原因，其在撒哈拉以南非洲地区的患病率正在上升，尤其是在青少年中。我们试图确定尼日利亚学校青少年吸烟的相关因素，并调查学校所在地与社会经济地位（SES）之间的相互作用。
采用横断面研究设计，通过分层两阶段整群抽样，选取了尼日利亚埃努古州农村和城市中学的4332名八年级至十年级学生。我们使用经过修改的全球青少年烟草调查（GYTS）核心问卷收集数据。结果指标为当前吸烟情况（香烟及其他烟草制品）。采用多水平混合效应逻辑回归模型确定与当前吸烟相关的因素，p<0.05时被认为具有统计学意义。
当前吸烟（香烟及其他烟草制品）的患病率分别为13.3%（95%CI：11.3 - 15.7）和5.8%（95%CI：4.6 - 7.2）。每周零花钱较多、接触二手烟或烟草广告、父母、朋友或同学吸烟以及学校附近有香烟售卖，均与当前吸烟呈正相关。女性、父母双方都有工作以及在学校接受烟草教育与当前吸烟呈负相关，而年龄增长和父亲的高社会经济地位与当前其他烟草制品的吸烟呈负相关。在吸烟与学校所在地和父亲的社会经济地位之间存在相互作用。与低社会经济地位的学生相比，高社会经济地位的学生父亲所在的农村学校与城市学校相比吸烟几率更高。在农村学校，高社会经济地位与较高的吸烟几率相关，但在城市学校，低社会经济地位与较高的吸烟几率相关。环境因素与青少年吸烟有关。烟草控制项目应采用根据当地情况而异的针对性策略。
