Juliette Lee

Change in tobacco use among 13—15 year olds between 1999 and 2008: findings from the Global Youth Tobacco Survey

Tobacco use is the leading preventable cause of death and disease in the world; yet little is known about the levels or patterns of youth tobacco use on a global basis. The purpose of this paper is to focus on change in youth tobacco use using data from 100 sites that have conducted repeat Global Youth Tobacco Surveys (GYTS). The GYTS is a school-based survey that collects data from students aged 13–15 years using a standardized methodology for constructing the sample frame, selecting schools and classes, and processing data. GYTS is conducted in school classes using self-administered anonymous data collection. The GYTS sample produces representative, independent, cross-sectional estimates for each sampling frame. Of the 100 sites surveyed, 61 reported no change over time in prevalence of cigarette smoking, likewise in 50 of the 97 sites with data on use of other tobacco products there was no change. However, 34 sites reported an increase in other tobacco use. This appears to be attributed to waterpipe, an emerging trend in tobacco use. Evidence was found supporting the idea that tobacco use among adolescent girls is likely increasing. The global tobacco control effort continues to face many challenges in reversing the tobacco epidemic. Few countries have implemented comprehensive tobacco control legislation laid out by the World Health Organization. The few countries that have adopted some of these proven policies can serve as examples in achieving positive results in curbing the tobacco epidemic. (Global Health Promotion, 2009; Supp (2): pp. 38–90)

Evolution of the Global Tobacco Surveillance System (GTSS) 1998–2008:

Tobacco use is one of the leading preventable causes of morbidity and mortality worldwide. Given that country-specific international data on tobacco use were limited or nonexistent, in 1998, the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the Canadian Public Health Association (CPHA) initiated the Global Tobacco Surveillance System (GTSS) to assist countries in establishing tobacco control surveillance and monitoring programs. GTSS includes collection of data through three school-based surveys: the Global Youth Tobacco Survey (GYTS) for youth; the Global School Personnel Survey (GSPS), and the Global Health Professions Student Survey (GHPSS) for adults; and one household survey: the Global Adult Tobacco Survey (GATS) for adults. The GTSS provides a globally implemented and consistent framework for conducting surveillance including standard sampling procedures, core questionnaire items, training in field procedures and analysis of data consistent across all GTSS countries. The GTSS also enhances the role of the nongovernmental sector by supporting participation of civil society agencies in surveillance, monitoring, and policy and program development. The synergy between countries passing tobacco control laws, regulations or decrees, ratifying and complying with the WHO Framework Convention on Tobacco Control, and conducting GTSS surveys offers a unique opportunity to develop, implement, and evaluate comprehensive tobacco control policy that can be helpful to each country document the development, growth, and collaboration in sustaining the GTSS. The report highlights countries’ involvement in tobacco control measures and the establishment of comprehensive tobacco control programs worldwide. This report can assist countries in prioritizing and developing tobacco control programs, including surveillance, evaluation, and policy development. (Global Health Promotion, 2009; Supp (2): pp. 04-37)

Prevalence of smoking and other smoking-related behaviors reported by the Global Youth Tobacco Survey (GYTS) in Thailand

IntroductionThailand ratified the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) on November 8, 2004. The WHO FCTC requires all parties to inform all persons of the health consequences of tobacco consumption and exposure to tobacco smoke. Each party has agreed to develop, implement and evaluate effective tobacco control programs to measure progress in reaching the goals of the WHO FCTC.MethodsThe Global Youth Tobacco Survey (GYTS) was developed to provide data on youth tobacco use to countries for their development of youth-based tobacco control programs. Data in this report can be used as baseline measures for future evaluation of the tobacco control programs implemented by the Ministry of Public Health.ResultsOverall, about 1 in 10 Thai students are current smokers, this number including 4 times more boys than girls (17% versus 3.9%). Almost 2 in 10 Thai students start smoking before the age of 10, and almost 7 in 10 students are reported to have been exposed to smoke from others in public places. About 4 in 10 students are reported to have an object with a cigarette brand logo on it.ConclusionThe key for Thailand is to implement and enforce the provisions on indirect tobacco advertising, smoking in public places, selling tobacco to youths under 18 years of age, and to use the data from the GYTS to monitor progress toward achieving the goals of the WHO FCTC. When these goals are met, tobacco consumption and exposure in Thailand will have declined substantially.

Tobacco use, exposure to secondhand smoke, and cessation counseling among medical students: cross-country data from the Global Health Professions Student Survey (GHPSS), 2005-2008

BackgroundGHPSS is a school-based survey that collects self-administered data from students in regular classroom settings. GHPSS produces representative data at the national or city level in each country. This study aims to investigate the prevalence of tobacco use, exposure to secondhand smoke, and cessation counseling among medical students using the GHPSS data.MethodsThe Global Health Professions Student Survey (GHPSS) was conducted among 3rd year medical students in 47 countries and the Gaza Strip/West Bank from 2005-2008 to determine the prevalence of tobacco use and amount of formal training in cessation counseling.ResultsIn 26 of the 48 sites, over 20% of the students currently smoked cigarettes, with males having higher rates than females in 37 sites. Over 70% of students reported having been exposed to secondhand smoke in public places in 29 of 48 sites. The majority of students recognized that they are role models in society (over 80% in 42 of 48 sites), believed they should receive training on counseling patients to quit using tobacco (over 80% in 41 of 48 sites), but few reported receiving formal training (less than 40% in 46 of 48 sites).ConclusionTobacco control efforts must discourage tobacco use among health professionals, promote smoke free workplaces, and implement programs that train medical students in effective cessation-counseling techniques.

Tobacco Use, Exposure to Secondhand Smoke, and Training on Cessation Counseling Among Nursing Students: Cross-Country Data from the Global Health Professions Student Survey (GHPSS), 2005–2009

The Nursing Global Health Professions Student Survey (GHPSS) has been conducted in schools in 39 countries and the Gaza Strip/West Bank (identified as “sites” for the remainder of this paper). In half the sites, over 20% of the students currently smoked cigarettes, with males having higher rates than females in 22 sites. Over 60% of students reported having been exposed to secondhand smoke in public places in 23 of 39 sites. The majority of students recognized that they are role models in society, believed they should receive training on counseling patients to quit using tobacco, but few reported receiving any formal training. Tobacco control efforts must discourage tobacco use among health professionals, promote smoke free workplaces, and implement programs that train health professionals in effective cessation-counseling techniques.

Smoking tobacco in waterpipes among adolescents in Europe: the case of Latvia and Slovakia

Recent studies have found the use of waterpipes among adolescents is increasing in popularity in Europe and the USA.1–5 Additionally, many users do not know that tobacco is the main component of the product smoked in waterpipes. The smoke from a waterpipe contains most of the same compounds present in cigarette smoke (eg, carbon monoxide, carcinogens, nicotine and heavy metals); additionally, studies have found that during a waterpipe session, smokers may inhale a volume of smoke equivalent to that produced by more than 100 cigarettes.1 3 6 Waterpipe users have been found to have increased risk for lung, oral and bladder cancer and heart disease.1 2 In addition, some studies have …

Tobacco use among Palestine refugee students (UNRWA) aged 13-15.

OBJECTIVE The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has made tobacco use prevention a primary health issue. UNRWA provides education, health, relief and social services in five fields of operation: Jordan, Lebanon, Syria, Gaza Strip and the West Bank. The purpose of this paper is to compare tobacco use among Palestine refugee students and students in the general population of the five fields of operation. METHODS Global Youth Tobacco Survey (GYTS) data were collected from representative samples of students in UNRWA schools in each of the five fields of operation in 2008. For comparison, previous data are included from GYTS conducted in Gaza Strip, Lebanon, and the West Bank (2005) and in Jordan and Syria (2007). Data are presented for three groups of students: refugees attending schools within and outside the camps and non-refugee students in the general population. RESULTS In each of the five fields of operation, there was no difference in current cigarette smoking, current use of shisha, or susceptibility to initiate smoking among the three groups of students. Cigarette smoking and susceptibility was lowest in the Gaza Strip and highest in the West Bank; shisha use was lowest in the Gaza Strip but over 30% in Lebanon, Syria, and the West Bank. Exposure to secondhand smoke in public places was greater than 60% in almost all sites. Exposure to indirect advertising was almost 10%. CONCLUSIONS The similarity in tobacco use among the three groups of students suggests that a coordinated plan between the UNRWA and the governmental authority could be most beneficial in reducing the burden of tobacco-related morbidity and mortality.

Exposure to and attitudes regarding secondhand smoke among secondary students in Taiwan

The 2003 School Health Act of Taiwan stipulated that school campuses of senior high and below should be smoke free, but data from the Global Youth Tobacco Survey show that the majority of students are exposed to smoke in public and at home. More than 50% of nonsmokers indicated that they had been exposed to secondhand smoke (SHS) in public places, with the exposure rate as high as 90% among smokers. More than 40% of junior and senior high school students were exposed to SHS at home. Support for banning smoking in public places ranged from almost 60% to almost 80%. More than 60% of current smokers and almost 90% of never smokers think that smoke from others is harmful to them. With a clear body of evidence detailing the harmful effects, reduction and eventual elimination of exposure to SHS should be the goal of the tobacco control community.