Changes in prevalence, and factors associated with tobacco use among Bangladeshi school students: evidence from two nationally representative surveys

Abstract

Background Globally, tobacco kills more than nine million people per year. Annually in Bangladesh, smoking accounts for 1.2 million illnesses and over one hundred fifty thousand deaths. Worldwide, about one out of five school students smoke tobacco, and this problem is also growing significantly in Bangladesh. There is a need to address this problem. However, to the best of knowledge, no published study has been evaluated the changes in factors associated with tobacco use over time among Bangladeshi adolescent students using large, nationally representative comparable surveys. Our objective was to identify the factors associated with tobacco use among school going students, examine any changes in them over time, and explore policy options based on national surveys. Methods We analysed the data from the 2007 and the 2013 Global Youth Tobacco Survey (GYTS), a school-based survey targeting adolescents age 13–15 years (7th–9th grade), developed by the World Health Organization (WHO) and the Centres for Disease Control and Prevention (CDC). The samples were selected based on a two-stage cluster sample design. The data were collected in school classes using a self-administered anonymous survey. We applied chi-square tests and survey logistic regression models for analysing the data. Results Overall tobacco usage significantly declined from 8.4 to 6.9% over six years. The prevalence of tobacco use decreased among females (5.22 to 2.84%), those who received anti-tobacco messages (8.93 to 7.24%) and because of age restriction could not buy tobacco products (18.86 to 15.78%). Compared with the female, the odds of overall tobacco smoking among male students was 1.97 (CI: 0.99–3.92) in the year 2007 and it increased (OR = 3.07; CI: 1.56–6.04) in the year 2013. Moreover, the odds of smoking among those exposed to tobacco smoke had increased (OR = 3.26; CI: 1.46–7.29 vs 5.43; CI: 1.63–18.07) from 2007 to 2013. Conclusion There was a decline in tobacco use, especially among female students. Male students were higher tobacco user. It appeared anti-smoking campaign and age restriction policies were working.

Was there any change in tobacco smoking among adults in Bangladesh during 2009–2017? Insights from two nationally representative cross-sectional surveys

“…13 Acknowledging the high burden of tobacco smoking worldwide, the WHO implemented the Framework Convention on Tobacco Control (FCTC) as well as the Protocol to Eliminate Illicit Trade in Tobacco Smoking Products. 3 The FCTC is further iterated in the Sustainable Development Goals, particularly target 3.a. Bangladesh is identified as the first signatory to the WHO FCTC.…”

“…2 With this high number of tobacco smokers worldwide, the WHO urged reducing tobacco use as it is quintessential to reducing the global burden of non-communicable diseases, which account for nearly 71% of global mortalities. 3 Tobacco smoking is a huge concern in low-income and middle-income countries as 80% of tobacco smokers reside in these regions. 2 4 Specifically, the South-East Asian region accounts for nearly 90% of the total tobacco smokers across the globe.…”

“…2 With this high number of tobacco smokers worldwide, the WHO urged reducing tobacco use as it is quintessential to reducing the global burden of non-communicable diseases, which account for nearly 71% of global mortalities. 3 …”

Implementation of Tobacco Control Policies in Bangladesh: A Political Economy Analysis

“…However, the shift of tobacco consumption from bidi 3 and smokeless tobacco use to cigarette smoking is a concern for policymakers and activists alike. The prevalence rate of adolescent tobacco use and second-hand smoking is still unsatisfactory (Ahammed et al, 2021;Shah et al, 2019). In a nutshell, the country has so far failed to achieve its targets and the vision of being tobacco-free by 2040 is very opaque, and unlikely to be met.…”

Raising the Age of Purchase and Use of Tobacco Product in Bangladesh: Benefits and Challenges in Protecting Youth from the Tobacco Epidemic

“…As per the internal tobacco industry documents produced during litigation between US states and the seven major tobacco industry organizations (later termed as the Master Settlement Agreement), a Phillip Morris memo, stated, "raising the legal minimum age for cigarette purchase (from 18) to 21 could gut our key young adult market" (Philip Morris). There is ample precedence that age restrictions work (Ahammed et al, 2021). Age restrictions are well-established and denormalize youths access to sin goods like alcohol, gambling, gun use, underage driving, and the use of drugs and dangerous substances.…”