Current Cigarette Smoking and Its Predictors among School-Going Adolescents in East Africa: A Systematic Review and Meta-Analysis

Abstract

Background. In developing countries, tobacco smoking has its own contribution to the burden of noncommunicable causes of morbidity and mortality. Studies estimated the burden of cigarette smoking among school-going adolescents in different geographical areas of East Africa. However, due to discrepancies found among those different findings, there is no representative data about the burden of smoking in the continent. Objectives. This systematic review and meta-analysis aimed to assess the pooled prevalence of current cigarette smoking and its associated factors among school-going adolescents in East Africa. Methods. PubMed, Google Scholar, and the Web of Science Library were searched to access included articles. A weighted inverse-variance random-effects model was used to estimate the prevalence of current cigarette smoking. Variations in the pooled estimates of the prevalence were adjusted through subgroup analysis according to the specific country, where the study was conducted. Funnel plot and Egger’s regression test were used to check publication bias. STATA version 14 statistical software was used for meta-analysis. Results. A total of 26,875 school-going adolescents were included. The pooled prevalence of current cigarette smoking among school-going adolescents in East Africa was found to be 9.02% (95%CI: 6.34-11.70). Based on the subgroup analysis, current cigarette smoking among school-going adolescents was estimated at 9.8% in Kenya, 7.72% in Ethiopia, 10.83% in Uganda, 13.6% in Sudan, and 4% in Tanzania. Conclusions. This meta-analysis revealed that the prevalence of current cigarette smoking is increasing among school-going adolescents in East Africa. Therefore, countries have to realize sale prevention policies, establishing and/or strengthening antismoking campaigners designed for school-going adolescents, and providing training for teachers to be antismoking campaigners.

Prevalence and Factors Associated with Current Cigarette Smoking among Ethiopian University Students: A Systematic Review and Meta-Analysis

“…is is consistent with other studies carried out in East Africa [35,45]. During adolescence and early adult years, individuals have a higher predisposition to imitate and exercise what they observe in their peer group.…”

“…is finding is similar to studies carried out globally with smoking prevalence reported at the University of East Africa as 9.02% [35]. Meta-analyses from Mainland Chinese and from the Kingdom of Saudi Arabia reported, respectively, university student smoking prevalence at 10.83% [36] and 17% [37].…”

Current and former smokers among adolescents aged 12–17 years in Iran: a systematic review and meta-analysis

“…Compared to international studies, our results are lower than those found in studies conducted in Saudi Arabia (19.5%) [72], India (11.8%) [73], Sudan (13.6%) [74] and Italy (35.6%) [75] and higher than the prevalence computed in studies carried out in Ethiopia (3%) [76] and China (7.93%) [77]. Our estimates were similar to the results of a metaanalysis conducted in East Africa (9.02%) [78]. The prevalence of former smoking behavior among Iranian adolescents was estimated to be 24%.…”

“…This difference in prevalence across studies can be due to social, cultural, health conditions, and legal factors [72,74,75,78]. Different study settings could explain the variability of the findings: some studies were done in schools and teachers were present when the data were collected.…”

“…The instant relaxation of a cigarette encourages cigarette consumption over time. In these people knowledge of emotion control skills and stress reduction strategies are very useful in preventing or, at least, reducing smoking behavior [78].…”