School tobacco-related curriculum and behavioral factors associated with cigarette smoking among school-going adolescents in Zambia: Results from the 2011 GYTS study

Abstract

INTRODUCTION Tobacco smoking is a global public health concern. It has been projected that children and young people who are alive today in developing countries will bear the most burden of tobacco-related morbidity and mortality in the near future. This study investigated the school tobacco-related curriculum and behavioral factors associated with cigarette smoking among school-going adolescents. METHODS We accessed secondary data in a public domain collected using a cross-sectional study design. Altogether, 3377 seventh to ninth grade students were selected by stratified two-stage cluster sampling. Data were collected using a Global Youth Tobacco Survey (GYTS) Core Questionnaire. Multivariate logistic regression models were used to determine associations of school tobacco-related curriculum and behavioral factors with current cigarette smoking status. Adjusted odds ratios and their 95% confidence intervals are reported. RESULTS Of the 2611students included in the analysis, 6.8% (7.8% of males and 5.8% of females) reported smoking cigarettes. Slightly over half of the students were taught in schools about the effects of smoking (53.6%) and the dangers of smoking (64.1%). Adolescents who had friends who smoked were more likely to smoke compared to those who did not have friends who smoked. Adolescents whose parents smoked were more likely to smoke compared to those who did not have parents who smoked. Adolescents who were not taught at school about the dangers of smoking, or were not sure about it, were more likely to smoke compared to those who were taught (AOR=1.94; 95% CI: 1.28–2.94). CONCLUSIONS Schools play an important role in shaping smoking behavior among school-going adolescents. Based on our findings, school programs aimed at reducing cigarette smoking among school-going adolescents may achieve greater impact by implementing anti-smoking interventions that involve parents and peers in smoking prevention activities, and have a robust tobacco school curriculum.

Prevalence and Factors Associated with Tobacco Smoking in a National Representative Sample of Zambian Adults: Data from the 2017 STEPS – NCDs Survey

“…As shown by the results of this study, of those who participated in the STEPS survey, 11.0% reported being current tobacco smokers. These findings are consistent with the previous surveys that have shown a national range of 6.8% to 11.89% (Cosmas, 2022;Nyirenda et al, 2019;Olowski P, 2016;S, 2009;Zulu R, 2008). Our estimate is slightly lower than what has been reported in other countries (Dickson et al, 2017), yet it remains notably higher than the tobacco smoking prevalence found in other sub-Saharan countries (Guliani et al, 2019;He et al, 2018).…”

“…This study shows that the prevalence of tobacco smoking in Zambia is of a public health concern and compared with previous national surveys; there has not been a significant overall reduction (Cosmas, 2022;Nyirenda et al, 2019;Olowski, 2016;S, 2009;Zulu, 2008) showing that there is need for implementation of interventions that impact behaviour change. As shown by the results of this study, of those who participated in the STEPS survey, 11.0% reported being current tobacco smokers.…”

“…In terms of the empirical literature, a plethora of studies have demonstrated an association between gender and tobacco smoking (Cosmas, 2022;Nyirenda et al, 2019;Olowski P, 2016;S, 2009;Zulu, 2008). Theilmann et al, (2022), examined household survey data from 82 low and middle income countries showed that women had less prevalence of tobacco smoking as compared to men in most of the countries.…”

“…The Zambia demographic health surveys (DHS) have shown overall prevalence ranging from 9.9% to 12.0% (Olowski, 2016), with males and rural areas smoking more than females and urban areas, respectively (Nyirenda et al, 2019;Olowski, 2016). The Global Youth Tobacco survey (GTYS) which tracks tobacco use in school-going adolescents has also indicated the overall prevalence range of 6.8% to 10.5% (Cosmas, 2022;S, 2009). Some authors have indicated boys and rural residence smoking more than girls and urban areas respectively (Cosmas, 2013b;S, 2009;Zulu, 2008).…”

“…While some studies on tobacco smoking have been conducted in Zambia (Cosmas, 2022;Nyirenda et al, 2019;Olowski, 2016;S, 2009;Zulu R, 2008), we are not aware of a study that has included the behavioral and psychological factors (mental health problems and alcohol consumption) and comorbidities such as CVD (heart attack and hypertension); and metabolic disorders (diabetes and dyslipidemia) in their analysis. We, therefore, use a nationally represented survey to report the sociodemographic, behavioral, and psychological factors; and clinical characteristics associated with tobacco smoking.…”