Evaluation of Smoking Habits Among Middle and High School Students in the Central Black Sea Region: A Comparative Analysis with Two Studies in the Same Region

Öz

Conventional Cigarette Smoking Among Adolescents in the Central Black Sea Region: A Comparative Analysis of Two Studies in the Same Region

Background: Smoking remains a significant and preventable public health problem affecting adolescents. This study evaluated the prevalence of conventional (packaged) cigarette use among middle and high school students, identified associated factors, and assessed temporal trends by comparing the findings with those of previous studies conducted in the same region.

Materials and Methods: A cross-sectional study was conducted with 785 students (383 males, 402 females; mean age 15.6±1.32 years) selected via stratified random sampling in the Samsun province. Data were collected using self-administered questionnaires. Chi-square tests and multivariate logistic regression were used for statistical analysis.

Results: The prevalence of conventional cigarette use was 3.82% (2.72% in males, 1.10% in females; p<0.05), representing a significant decline compared with rates reported in the same region in 1997 (13.1%) and 2012 (13.0%) (p<0.0005). The mean age at smoking initiation was 13.6±1.31 years, with females starting later than males (14.0±1.38 vs. 13.2±1.62 years; p<0.001). In multivariate analysis, peer smoking was the strongest predictor (β=0.613), followed by parental smoking (β=0.286) and sibling smoking (β=0.144). The primary reasons for initiation were stress/boredom (43.3%) and peer influence (40.0%). Among students, 44.1% had smoking fathers, 21.4% had smoking mothers, 8.9% had smoking siblings, and 35.3% had smoking peers. While 44.8% recognized respiratory harms and 29.6% recognized cancer risks, only 33.2% believed public service announcements would be effective.

Discussion: Conventional cigarette use has decreased markedly; peer and family influences are the principal determinants. E-cigarettes and novel nicotine products were not assessed; future studies should encompass all nicotine products.

Anahtar Kelimeler

• Adolescent smoking
• Conventional cigarettes
• Peer influence
• Family smoking
• Tobacco control
• E-cigarettes
• Smoking prevention

Kaynakça

1. Dai X, Gakidou E, Lopez AD. Evolution of the global smoking epidemic over the past half century: strengthening the evidence base for policy action. Tob Control. 2022 Mar;31(2):129-137. doi: 10.1136/tobaccocontrol-2021-056535. PMID: 35241576. google scholar
2. Campaign for Tobacco-Free Kids. The toll of tobacco in Turkey. Campaign for Tobacco-Free Kids. Available from: https://www.tobaccofreekids.org/ google scholar
3. Tate C, Kumar R, Murray JM, Sanchez-Franco S, Montgomery SC, Montes F, Dunne L, Sarmiento OL, Kee F, Hunter RF. Socio-environmental and psychosocial predictors of smoking susceptibility among adolescents with contrasting socio-cultural characteristics: a comparative analysis. BMC Public Health. 2021 Dec 9;21(1):2240. doi: 10.1186/s12889-021-12351-x. PMID: 34886840; PMCID: PMC8662882. google scholar
4. Sancak R, Dündar C, Öztürk F. Kırsal alandaki lise ve ortaokul öğrencilerinde sigara içme durumu. Çocuk Sağlığı ve Hastalıkları Dergisi 1997; 40: 385-393 google scholar
5. Akca G, Guner SN, Akca U, Kilic M, Sancak R, Ozturk F. Students' unchanging smoking habits in urban and rural areas in the last 15 years. Pediatr Int. 2016 Apr;58(4):279-83. doi: 10.1111/ped.12814. Epub 2016 Feb 15. PMID: 26291719. google scholar
6. Akkuş D, Bekar M. Lise öğrencileri arasında sigara ve alkol kullanma sıklığı ve etkileyen faktörler. Anadolu Klin Tıp Bil Derg. 2017;22(1):1-12. doi:10.21673/anadoluklin.245632. google scholar
7. Emekdar G, Çıtıl R, Önder Y, Bulut YE, Yaşayancan Ö, Kazancı NÖ, Sönmezgöz E, Eğri M. Tokat İli Ortaokul ve Lise Öğrencilerinde Sigara İçme Prevalansı ve Etkileyen Faktörler. Çağdaş Tıp Derg. 2017;7(1):58-66. doi:10.16899/gopctd.286207 google scholar
8. National Institute on Drug Abuse. Are there gender differences in tobacco smoking? [Internet]. 2020. Available from: https://nida.nih.gov/publications/research-reports/ tobacco-nicotine-e-cigarettes/are-there-gender-differences-in-tobacco-smoking. google scholar

9. Tobacco Induced Diseases. Gender differences in use of cigarette and non-cigarette tobacco products among adolescents aged 13-15 years in 20 African countries [Internet]. 2020. Available from: https://www.tobaccoinduceddiseases.org google scholar
10. M Bacikova-Sleskova, J Benka, O Kalina, O Orosova, Mediators of parental smoking behaviour and smoking experience of early adolescents: Maria Bacikova-Sleskova, European Journal of Public Health, Volume 25, Issue suppl_3, October 2015, ckv175.190, https://doi.org/10.1093/eurpub/ckv175.190 google scholar
11. Alves J, Perelman J, Soto-Rojas V, Richter M, Rimpelä A, Loureiro I, Federico B, Kuipers MAG, Kunst AE, Lorant V. The role of parental smoking on adolescent smoking and its social patterning: a cross-sectional survey in six European cities. J Public Health (Oxf). 2017 Jun 1;39(2):339-346. doi: 10.1093/pubmed/fdw040. PMID: 27160860. google scholar
12. Lin M, Chu M, Li X, Ma H, Fang Z, Mao L, Wang P, Chen T, Chiang YC. Factors influencing adolescent experimental and current smoking behaviors based on social cognitive theory: A cross-sectional study in Xiamen. Front Public Health. 2023 Mar 22;11:1093264. doi: 10.3389/fpubh.2023.1093264. PMID: 37033036; PMCID: PMC10073720. google scholar
13. Colston DC, Xie Y, Thrasher JF, Patrick ME, Titus AR, Emery S, McLeod MC, Elliott MR, Fleischer NL. Examining Truth and State-Sponsored Media Campaigns as a Means of Decreasing Youth Smoking and Related Disparities in the United States. Nicotine Tob Res. 2022 Mar 1;24(4):469-477. doi: 10.1093/ntr/ntab226. PMID: 34718762; PMCID: PMC8887582. google scholar
14. Jenssen BP, Walley SC, Boykan R, Little Caldwell A, Camenga D; SECTION ON NICOTINE AND TOBACCO PREVENTION AND TREATMENT; COMMITTEE ON SUBSTANCE USE AND PREVENTION. Protecting Children and Adolescents From Tobacco and Nicotine. Pediatrics. 2023 May 1;151(5):e2023061804. Doi: 10.1542/peds.2023-061804. PMID: 37066685. google scholar
15. World Health Organization. WHO report on the global tobacco epidemic 2023: enforcing bans on tobacco advertising, promotion and sponsorship. [Internet]. Geneva: World Health Organization; 2023 [cited 2023 Sep 29]. Available from: https://www.who.int/ publications/i/item/9789240066069 google scholar