Abstract
Abstract
Tobacco use is a preventable cause of disease and death globally. Adolescents using tobacco tend to continue its use in adulthood. Analysis of data from Moroccan Global School-based Student Health Surveys for 2006 and 2010 showed statistically significant differences in prevalence of current cigarette smoking as well as current use of other tobacco products, among school attending 13-15 year old boys and girls within the year 2006 and 2010; with boys having higher prevalence than girls in each year. Combined prevalence of cigarette smoking i.e. between both boys and girls showed statistically significant difference between 2006 and 2010; with a higher prevalence in 2010. Use of tobacco in multivariate analysis of 2010 data, was found to have statistically significant associations with anxiety disorders, gender, truancy, depression, suicidal ideation, inadequate parental monitoring, and parental smoking.
Keywords: Tobacco Use, Adolescents, Morocco.
Introduction
Tobacco use is a major cause of premature death and a leading but an entirely preventable risk factor for many chronic diseases including cancers, respiratory and cardiovascular diseases.1-4 Many health behaviours including smoking begin in adolescence that is often carried into adulthood.5-7 Tobacco use among adolescents has been associated with anxiety disorders, truancy, depression, suicidal ideation, inadequate parental monitoring, and parental smoking.7-11 Two previous nationally representative surveys i.e. \'Global Adult Tobacco Surveys\' (GATS) in Morocco on tobacco use among 13 to 15 years old reported the cumulative prevalence rate of cigarette smoking as 2.6% (95% CI: 1.9, 3.4), and 3.5% (95% CI: 2.7, 6.4) in 2001 and 2006, respectively.12 Prevalence rates for boys were 3.9% (95% CI: 2.9, 5.3) and 4.3% (2.9, 6.4) in 2001 and 2006, respectively. While for girls prevalence rates were 1.0% (95% CI: 0.4, 2.2) and 2.1% (95% CI: 1.1, 3.9) in 2001 and 2006, respectively. Cumulative prevalence rates for use of other tobacco products were 9.2% (95% CI: 8.1, 10.5) and 9.0% (95% CI: 7.5, 10.8) in 2001 and 2006, respectively. Prevalence rates for boys were 10.4% (95% CI: 9.0, 11.9) and 10.3% (95% CI: 7.8, 13.5) in 2001 and 2006, respectively. While for girls prevalence rates were 7.6% (95%CI: 6.0, 9.7) and 6.9% (95% CI: 5.5, 8.7) in 2001 and 2006, respectively.12 Two new nationally representative surveys i.e. Global School-based Student Health Surveys have been conducted, and in this study results are presented on prevalence, correlates, and changes in tobacco use between 2006 and 2010 among 13-15 year olds among Moroccan school attending adolescents.
Methods and Results
The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and the Moroccan national authorities have conducted Global School-based Student Health Surveys (GSHS) in Morocco, in 2006 and 2010. Both surveys used similar methodology by employing a two-stage cluster sample design to produce nationally representative estimates for all students in the 1st, 2nd, and 3rd Prep. Schools were selected using probability proportional to size during the first stage, while classes were randomly selected in the second stage; with all students being eligible to participate in the selected classes. The details of both surveys as well as data are available, and were accessed from the CDC\'s GSHS website.13 To describe factors associated with self-reported current tobacco use; defined as having smoking cigarettes and/or having used other tobacco products on one or more days in the past 30 days, in Moroccan school attending adolescents aged 13 to 15 year old, data for 2010 GSHS were used. While comparisons were made between the prevalence of cigarette smoking, and use of other tobacco products, between boys and girls; as well as between the two GSHS surveys of 2006 and 2010. In addition comparisons were also made between 2006 and 2010 for parental use of tobacco products and exposure to other people smoking in the presence of adolescents. Design-based analysis using STATA-13 was done using simple and multivariate logistic regression; factors found statistically significant at p
