Factors affecting Current Smoking among Adolescent Students of Dharan Municipality, Eastern Nepal: a Cross Sectional Questionnaire Survey

INTRODUCTION: Tobacco use is the single major preventable cause of death. Smoking is prevalent in all age groups but adolescents are often the target for tobacco industries and are vulnerable to tobacco addiction in the future with longer years of exposure and adverse consequences. This study aims to estimate the prevalence of current smoking and affecting factors among adolescent students of Dharan Municipality in Eastern Nepal.  

METHODS: A cross sectional study was conducted using pre tested self administered questionnaire adapted from Global Youth Tobacco Survey to assess current smoking among the representative sample of 1312 adolescent students in middle (14-15 years) and late adolescence (16-19 years) selected by stratified random sampling from July 2011 to June 2012. Chi square test and binary logistic regression analysis were performed with level of significance set at 5%. 

RESULTS: Prevalence of current smoking was 13.8% (95%CI 11.9 to 15.6). Nearly two third of smokers (66.5%) had attempted to quit smoking in the past, thinking that smoking is injurious to health (35.5%). Median duration of quitting was 150 days (Inter-quartile range 60 to 315 days). More than half of the smokers (53.8%) preferred to smoke in public places and nearly four fifth (81.3%) purchased cigarettes directly from the shops. Mean age of initiation of smoking was 14 years (SD= 2.30). Nearly 8% of smokers were unwilling to quit citing the major reason that smoking was already a habit (60%). Current smoking was associated with male gender (OR=15.8; 95% CI 8.14 to 30.92), Janajati ethnicity (OR=1.66; 95% CI 1.04 to 2.66) and ever use of alcohol (OR=4.83; 95% CI 3.17 to 7.36) after multivariate analysis.

CONCLUSIONS: Male students, students belonging to Janajati ethnicity and ever users of alcohol were significantly more likely to be current smokers after multivariate analysis.