Risk factors associated with adolescents smoking in Mongolia

Abstract

Risk factors associated with Adolescents Smoking in Mongolia Otgonsukh Sodnom Graduate School Public Health of Yonsei University, Republic of Korea Introduction: Based on a large national dataset, we conducted an investigation to identify the risk factors associated with adolescent smoking in Mongolia. It also aims to incorporate health curricula and policies on how to prevent these from identifying risk factors. Methods: The retrospective, cross-sectional descriptive was performed. Pooled cross-sectional data from the Global School-based Student Health Survey (2013) were analyzed, which consists of 5393 adolescence (11-18 years) students in the country. Bivariate and multivariate analyses were performed to identify the risk factors for current smoking in adolescents. Results: A total of 5393 school adolescents participated in the survey and an overall response rate was 88%. A total of 5322 adolescence students completed usable questionnaires for current smoking. The prevalence of current smoking was 8.4% (451 students). Among the male, 68.7% (310) were current smokers and female, current smokers were 31.2% (141). However, the majority, 57.9% (3084) were aged 13-15, 30% (1599) was 16 years older. The current smoker in the majority age, 16-18 were 59.2% (267), and between aged 13-15 were 38.3% (173). The risk factors for the current smokers were higher than the non-smokers. Being physical fights (72.7% vs 2.5, P 0.001), Parents smoking (53.8% vs 4.2%, P 0.001), Ever smoking (50.7% vs 4.5%, P 0.001), Drinking alcohol ( 47.4% vs 4.6%, P 0.001), Being physical attacked (47% vs 4.9%, P 0.001), Being bullied (32.5% vs 5.8%, P 0.001), Parents did not understand their problem (18.6% vs 7.5%, P 0.001) and using drug (16.7 vs 8.5%, P 0.001). A total of 5262 (97.5%) adolescence students completed usable questionnaires for the ever smoking. The prevalence of ever-smoking was 23.2% and 1224 adolescence students reported they have at some point smoked a cigarette before age 14 years. Among the 46.5% (2440) male, 59.7% (731) was ever smokers. Of the 53.4% (2802) female, ever smokers were 28.9% (354). The ever smoker aged between 16-18 was 43.1% (528). Similarly to older-aged adolescents, the ever smoker among 13-15 ages ever smokers were 42.4% (520) and the never smoker was 47.7% (2501). The higher risk factor was found in ever smokers student. Being physical fights (56.2% vs 9.8, P<0.001), Parents smoking (45.2% vs 13.2%, P< 0.001), Current smoking (36.8% vs 15.7, P<0.001), Being physical attacked (36.1% vs 16.1%, P<0.001), Being bullied (29% vs 16.8%, P<0.001) and Drinking alcohol (25% vs 18.8%, P<0.001). However, the risk factor for ever-smoking related to lack of parents understands their problem was lower than never smokers (18.5% vs 21.1%, P<0.001) and Using drugs (2.8% vs 25.9%, P<0.001) as well. In a bivariate model, the adolescents in the ‘current smoker’ had high increased odds of drinking alcohol (OR 10, 95% CI 8.49-11.9), using drugs (OR 5.48, 95% CI 2.89-10.3) and increased odds of age, years (OR 2.66, 95% CI 2.26-3.14), being physical fights (OR 2.53, 95% CI 2.11-3.03), gender (male) (OR 1.95, 95% CI 1.66-2.32), being physically attacked (OR 1.61, 95% CI 1.36-1.92), lack of parents understanding their problems (OR 1.47, 95% CI 1.22- 1.78), parents use of tobacco (OR 1.31, 95% CI 1.12-1.53) and being bullied (OR 1.09, 95% CI 0.91to 1.30) as well. In the further study, the multivariable analysis showed that current adolescents smoking were highly likely to be associated with drinking alcohol (OR 10.5, 95% CI 7.96-13.8), lack of parents understand their problem (OR 6.78, 95% CI 6.61-8.18), using drugs (OR 6.54, 95% CI 2.55-16.7), and high associated with age(years) (OR 3.10, 95% CI 2.49-3.85), gender (male) (OR 2.86, 95% CI 2.45-3.85), being physical fights (OR 2.71, 95% CI 2.03-3.63), being physically attacked (OR 1.57, 95% CI 1.19-2.07), parents use of tobacco (OR 1.32, 95% CI 1.03-1.60), and being bullied (OR 1.21, 95% CI 0.87-1.68). Conclusion: Among the control variables, age, gender, being bullied, frequency of getting into physical fights, being physically attacked, drinking alcohol, using drugs, lack of parents understand their problem and parents smoking were significantly related to the higher frequency of smoking. The current smokers in the majority age, 16-18 were 59.2%, and those who ever smoked were aged between 16-18 which was about 43.1%. The study identified a number of risk factors among current smoking and those who ever smoked before the age of 14 years. High-risk factors identified for current smokers and among those who ever smoked include; physical fights, parental smoking, parents understand their problem, bullying, having been physically attacked using drugs and drinking alcohol. The factors among the ever smoking students that were not necessarily high-risk factors were using drugs. The study suggested that we have to develop a school health program and organize a social community team that including their parents' particular focus on young adolescents, as smoking is often initiated early. School-based health programs should be including which take the high-risk factors associated with current smoking and ever smoking among school-going adolescents in Mongolia into consideration. Finally, we need in a long-term study, it is advisable to examine the various factors and their sensitivity to the causes of smoking.