Advertisement

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

Abstract

Objectives

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

Methods

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.

Results

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.

Conclusions

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.

Keywords

Adolescent Age of smoking initiation Global Youth Tobacco Survey Africa 

Notes

Acknowledgments

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.

Funding

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

Conflict of interest

All authors declares no conflict of interest.

References

  1. Blum RW (2007) Youth in sub-Saharan Africa. J Adolesc Health 41:230–238. doi: 10.1016/j.jadohealth.2007.04.005 CrossRefPubMedGoogle Scholar
  2. Bonita R, Magnusson R, Bovet P, Zhao D, Malta DC, Geneau R, Suh I, Thankappan KR, McKee M, Hospedales J, de Courten M, Capewell S, Beaglehole R, Lancet NCDAG (2013) Country actions to meet UN commitments on non-communicable diseases: a stepwise approach. Lancet 381:575–584. doi: 10.1016/S0140-6736(12)61993-X CrossRefPubMedGoogle Scholar
  3. Breslau N, Peterson EL (1996) Smoking cessation in young adults: age at initiation of cigarette smoking and other suspected influences. Am J Public Health 86:214–220CrossRefPubMedPubMedCentralGoogle Scholar
  4. Cairney P, Mamudu H (2014) The global tobacco control ‘endgame’: change the policy environment to implement the FCTC. J Public Health Policy 35:506–517. doi: 10.1057/jphp.2014.18 CrossRefPubMedGoogle Scholar
  5. Calo WA, Krasny SE (2013) Environmental determinants of smoking behaviors: the role of policy and environmental interventions in preventing smoking initiation and supporting cessation. Curr Cardiovasc Risk Rep 7:446–452. doi: 10.1007/s12170-013-0344-7 CrossRefPubMedPubMedCentralGoogle Scholar
  6. DeBry SC, Tiffany ST (2008) Tobacco-induced neurotoxicity of adolescent cognitive development (TINACD): a proposed model for the development of impulsivity in nicotine dependence. Nicotine Tob Res 10:11–25. doi: 10.1080/14622200701767811 CrossRefPubMedGoogle Scholar
  7. General USPHSOotS (2007) Children and secondhand smoke exposure excerpts from The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. US Department of Health and Human Services, Public Health Service, Office of the Surgeon General, RockvilleGoogle Scholar
  8. Gwede CK, McDermott RJ, Westhoff WW, Mushore M, Mushore T, Chitsika E, Majange CS, Chauke P (2001) Health risk behavior of rural secondary school students in Zimbabwe. Health Educ Behav 28:608–623CrossRefPubMedGoogle Scholar
  9. Hipple B, Lando H, Klein J, Winickoff J (2011) Global teens and tobacco: a review of the globalization of the tobacco epidemic. Curr Probl Pediatr Adolesc Health Care 41:216–230. doi: 10.1016/j.cppeds.2011.02.010 CrossRefPubMedGoogle Scholar
  10. Jackson C (1997) Initial and experimental stages of tobacco and alcohol use during late childhood: relation to peer, parent, and personal risk factors. Addict Behav 22:685–698CrossRefPubMedGoogle Scholar
  11. Kontis V, Mathers CD, Rehm J, Stevens GA, Shield KD, Bonita R, Riley LM, Poznyak V, Beaglehole R, Ezzati M (2014) Contribution of six risk factors to achieving the 25 × 25 non-communicable disease mortality reduction target: a modelling study. Lancet 384:427–437. doi: 10.1016/S0140-6736(14)60616-4 CrossRefPubMedGoogle Scholar
  12. Lando HA, Hipple BJ, Muramoto M, Klein JD, Prokhorov AV, Ossip DJ, Winickoff JP (2010) Tobacco is a global paediatric concern. Bull World Health Org 88:2. doi: 10.2471/BLT.09.069583 CrossRefPubMedPubMedCentralGoogle Scholar
  13. Legresley E, Lee K, Muggli ME, Patel P, Collin J, Hurt RD (2008) British American Tobacco and the “insidious impact of illicit trade” in cigarettes across Africa. Tob Control 17:339–346. doi: 10.1136/tc.2008.025999 CrossRefPubMedPubMedCentralGoogle Scholar
  14. Leventhal H, Cleary PD (1980) The smoking problem: a review of the research and theory in behavioral risk modification. Psychol Bull 88:370–405CrossRefPubMedGoogle Scholar
  15. Maassen IT, Kremers SP, Mudde AN, Joof BM (2004) Smoking initiation among Gambian adolescents: social cognitive influences and the effect of cigarette sampling. Health Educ Res 19:551–560. doi: 10.1093/her/cyg077 CrossRefPubMedGoogle Scholar
  16. Mamudu HM, John RM, Veeranki SP, Ouma AE (2013a) The odd man out in Sub-Saharan Africa: understanding the tobacco use prevalence in Madagascar. BMC Public Health 13:856. doi: 10.1186/1471-2458-13-856 CrossRefPubMedPubMedCentralGoogle Scholar
  17. Mamudu HM, Veeranki SP, John RM (2013b) Tobacco use among school-going adolescents (11–17 years) in Ghana. Nicotine Tob Res 15:1355–1364. doi: 10.1093/ntr/nts269 CrossRefPubMedGoogle Scholar
  18. Mamudu HM, Veeranki SP, John RM, Kioko DM, Ogwell Ouma AE (2015) Secondhand smoke exposure among nonsmoking adolescents in West Africa. Am J Public Health 105:1823–1830. doi: 10.2105/AJPH.2015.302661 CrossRefPubMedGoogle Scholar
  19. Munodawafa D, Marty PJ, Gwede C (1992) Drug use and anticipated parental reaction among rural school pupils in Zimbabwe. J Sch Health 62:471–474CrossRefPubMedGoogle Scholar
  20. Murnaghan DA, Leatherdale ST, Sihvonen M, Kekki P (2008) A multilevel analysis examining the association between school-based smoking policies, prevention programs and youth smoking behavior: evaluating a provincial tobacco control strategy. Health Educ Res 23:1016–1028. doi: 10.1093/her/cyn034 CrossRefPubMedGoogle Scholar
  21. Odukoya OO, Odeyemi KA, Oyeyemi AS, Upadhyay RP (2013) Determinants of smoking initiation and susceptibility to future smoking among school-going adolescents in Lagos State, Nigeria. Asian Pac J Cancer Prev 14:1747–1753CrossRefPubMedGoogle Scholar
  22. Pampel F (2008) Tobacco use in sub-Sahara Africa: estimates from the demographic health surveys. Soc Sci Med 66:1772–1783. doi: 10.1016/j.socscimed.2007.12.003 CrossRefPubMedPubMedCentralGoogle Scholar
  23. Peltzer K (2011a) Determinants of exposure to second-hand tobacco smoke (SHS) among current non-smoking in-school adolescents (aged 11–18 years) in South Africa: results from the 2008 GYTS study. Int J Environ Res Public Health 8:3553–3561. doi: 10.3390/ijerph8093553 CrossRefPubMedPubMedCentralGoogle Scholar
  24. Peltzer K (2011b) Early smoking initiation and associated factors among in-school male and female adolescents in seven African countries. Afr Health Sci 11:320–328PubMedPubMedCentralGoogle Scholar
  25. Reidpath DD, Davey TM, Kadirvelu A, Soyiri IN, Allotey P (2014) Does one cigarette make an adolescent smoker, and is it influenced by age and age of smoking initiation? Evidence of association from the US Youth Risk Behavior Surveillance System (2011). Prev Med 59:37–41. doi: 10.1016/j.ypmed.2013.11.011 CrossRefPubMedGoogle Scholar
  26. Swart D (1998) Cigarette smoking initiation and maintenance. Int J Adolesc Med Health 10:51–63. doi: 10.1515/IJAMH.1998.10.1.51 CrossRefGoogle Scholar
  27. Swart D, Panday S, Reddy SP, Bergstrom E, de Vries H (2006) Access point analysis: what do adolescents in South Africa say about tobacco control programmes? Health Educ Res 21:393–406. doi: 10.1093/her/cyl042 CrossRefPubMedGoogle Scholar
  28. Thun M, Peto R, Boreham J, Lopez AD (2012) Stages of the cigarette epidemic on entering its second century. Tob Control 21:96–101. doi: 10.1136/tobaccocontrol-2011-050294 CrossRefPubMedGoogle Scholar
  29. Townsend L, Flisher AJ, Gilreath T, King G (2006) A systematic literature review of tobacco use among adults 15 years and older in sub-Saharan Africa. Drug Alcohol Depend 84:14–27. doi: 10.1016/j.drugalcdep.2005.12.008 CrossRefPubMedGoogle Scholar
  30. Unwin N, Epping Jordan J, Bonita R (2004) Rethinking the terms non-communicable disease and chronic disease. J Epidemiol Community Health 58:801 (author reply 801) CrossRefPubMedPubMedCentralGoogle Scholar
  31. USDHHS (United States Department of Health and Human Services) (2012) Preventing tobacco use among youth and young adults: a report of the Surgeon General. http://www.ncbi.nlm.nih.gov/pubmed/22876391
  32. Veeranki SP, Mamudu HM, Anderson JL, Zheng S (2014) Worldwide never-smoking youth susceptibility to smoking. J Adolesc Health 54:144–150. doi: 10.1016/j.jadohealth.2013.07.036 CrossRefPubMedGoogle Scholar
  33. Veeranki SP, Alzyoud S, Kheirallah KA, Pbert L (2015a) Waterpipe use and susceptibility to cigarette smoking among never-smoking youth. Am J Prev Med. doi: 10.1016/j.amepre.2015.03.035 PubMedGoogle Scholar
  34. Veeranki SP, Mamudu HM, John RM, Ouma AE (2015b) Prevalence and correlates of tobacco use among school-going adolescents in Madagascar. J Epidemiol Glob Health 5:239–247. doi: 10.1016/j.jegh.2014.12.005 CrossRefPubMedGoogle Scholar
  35. Veeranki SP, Mamudu HM, Zheng S, John RM, Cao Y, Kioko D, Anderson J, Ouma AE (2015c) Secondhand smoke exposure among never-smoking youth in 168 countries. J Adolesc Health 56:167–173. doi: 10.1016/j.jadohealth.2014.09.014 CrossRefPubMedGoogle Scholar
  36. Warner KE (2007) Charting the science of the future where tobacco-control research must go. Am J Prev Med 33:S314–S317. doi: 10.1016/j.amepre.2007.09.010 CrossRefPubMedGoogle Scholar
  37. Warren CW, Lee J, Lea V, Goding A, O’Hara B, Carlberg M, Asma S, McKenna M (2009) Evolution of the global tobacco surveillance system (GTSS) 1998–2008. Glob Health Promot 16:4–37. doi: 10.1177/1757975909342181 CrossRefPubMedGoogle Scholar
  38. WHO (World Health Organization) (2009) WHO report on the global tobacco epidemic, 2009: implementing smoke-free environments. http://www.who.int/tobacco/mpower/2009/gtcr_download/en/index.html
  39. Widome R, Samet JM, Hiatt RA, Luke DA, Orleans CT, Ponkshe P, Hyland A (2010) Science, prudence, and politics: the case of smoke-free indoor spaces. Ann Epidemiol 20:428–435. doi: 10.1016/j.annepidem.2010.03.004 CrossRefPubMedGoogle Scholar
  40. Yach D, Bettcher D (2000) Globalisation of tobacco industry influence and new global responses. Tob Control 9:206–216CrossRefPubMedPubMedCentralGoogle Scholar

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

Personalised recommendations