International Journal of Public Health

, Volume 62, Issue 1, pp 63–72 | Cite as

Age of smoking initiation among adolescents in Africa

  • Sreenivas P. VeerankiEmail author
  • Rijo M. John
  • Abdallah Ibrahim
  • Divya Pillendla
  • James F. Thrasher
  • Daniel Owusu
  • Ahmed E. O. Ouma
  • Hadii M. Mamudu
Original Article



To estimate prevalence and identify correlates of age of smoking initiation among adolescents in Africa.


Data (n = 16,519) were obtained from nationally representative Global Youth Tobacco Surveys in nine West African countries. Study outcome was adolescents’ age of smoking initiation categorized into six groups: ≤7, 8 or 9, 10 or 11, 12 or 13, 14 or 15 and never-smoker. Explanatory variables included sex, parental or peer smoking behavior, exposure to tobacco industry promotions, and knowledge about smoking harm. Weighted multinomial logit models were conducted to determine correlates associated with adolescents’ age of smoking initiation.


Age of smoking initiation was as early as ≤7 years; prevalence estimates ranged from 0.7 % in Ghana at 10 or 11 years age to 9.6 % in Cote d’Ivoire at 12 or 13 years age. Males, exposures to parental or peer smoking, and industry promotions were identified as significant correlates.


West African policymakers should adopt a preventive approach consistent with the World Health Organization Framework Convention on Tobacco Control to prevent an adolescent from initiating smoking and developing into future regular smokers.


Adolescent Age of smoking initiation Global Youth Tobacco Survey Africa 



The authors would like to thank all personnel, including study participants, study coordinators and organizations involved with the Global Youth Tobacco Survey. In particular, the authors would like to acknowledge the U.S. Centers for Disease Control and Prevention for making the data publicly available through the GTSS data portal.

Compliance with ethical standards

Ethical approval

This article includes secondary data analysis of publicly available data.

This article does not contain any studies with human participants or animals performed by any of the authors.


The authors declare that no external funds were used to conduct this study.

Conflict of interest

All authors declares no conflict of interest.


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Copyright information

© Swiss School of Public Health (SSPH+) 2016

Authors and Affiliations

  • Sreenivas P. Veeranki
    • 1
    Email author
  • Rijo M. John
    • 2
  • Abdallah Ibrahim
    • 3
  • Divya Pillendla
    • 1
  • James F. Thrasher
    • 4
  • Daniel Owusu
    • 5
  • Ahmed E. O. Ouma
    • 6
  • Hadii M. Mamudu
    • 4
  1. 1.Department of Preventive Medicine and Community HealthUniversity of Texas Medical BranchGalvestonUSA
  2. 2.Indian Institute of TechnologyJodhpurIndia
  3. 3.School of Public HealthUniversity of GhanaAccraGhana
  4. 4.Department of Health Promotion, Education, and Behavior, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA
  5. 5.Department of Biostatistics and Epidemiology, Health Policy and Management, College of Public HealthEast Tennessee State UniversityJohnson CityUSA
  6. 6.Tobacco ControlWHO Regional Office for AfricaBrazzavilleCongo

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