The role of parents, friends, and teachers in adolescents tobacco habits

Overview & Synopsis

Objective: To assess the influence of parental, friends', and teachers' smoking and tombak dipping on cigarette smoking and tombak dipping by school-going Sudanese adolescents. Design: A school-based cross-sectional survey was conducted in 2005-2006. Logistic regression was used for the analysis. Subjects: 4277 Sudanese school-going adolescents (aged 11-17 years) from 23 schools who completed an anonymous self-administered questionnaire on the use of tobacco products. Main outcome measures: Self-reported tobacco use during the previous month defined current tobacco use. Ever smoking, tombak (local smokeless tobacco) dipping, and other tobacco products were also considered as outcomes. Results: After adjusting for sex, age and school grade, adolescents' smoking habits were strongly associated with the habit in their parents and friends and, more weakly, with teachers' tombak dipping. When adjusted for each other, the association with smoking in friends was unaffected and remained significant (prevalence odds ratio [POR] of having ever smoked was 1.94, 95% confidence interval [CI] 1.64 to 2.29; OR of being current smoker was 3.77 (95% CI 2.80 to 5.07). Tobacco smoking in friends was positively associated with adolescents ever tombak dipping (POR 1.81, 95% CI 1.41 to 2.33) and current dipping (OR 3.33, 95% CI 2.20 to 5.05). The association with parental habits was reduced but still significantly elevated. Teachers' tombak dipping was only associated with adolescents ever tobacco smoking. Conclusion: Parental, teachers', and friends' tobacco use was associated with adolescents' tobacco habits. The influence of friends was the strongest. In developing programmes against adolescents' tobacco habits, there is need to target the influence of these ‘significant others'. Sudan needs to develop and implement comprehensive anti-smoking and anti-tombak dipping legislation to reduce the growing prevalence of the habits.