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International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board Member: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel

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2191-0278
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In This Section
Volume 26, Issue 2 (May 2014)

Issues

Clustering of risk factors in the smoking habits of schoolchildren in Sousse, Tunisia

Asma Nouira
  • Corresponding author
  • Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
  • Email:
/ Jihen Maatoug
  • Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
/ Imed Harrabi
  • Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
/ Sonia Hmad
  • Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
/ Mmyléne Belkacem
  • Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
/ Slim Slama
  • Department of Community Medicine, Primary care and Emergency, University Hospitals of Geneva, Switzerland
/ Mustafa al’Absi
  • Duluth Medical Research Institute, University of Minnesota, MN, USA
/ Harry Lando
  • Department of Epidemiology and Community Health, University of Minnesota, MN, USA
/ Hassen Ghannem
  • Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia
Published Online: 2013-07-26 | DOI: https://doi.org/10.1515/ijamh-2013-0511

Abstract

Background: In Tunisia, little is known about the association between tobacco use and other chronic disease risk factors. This is the case for both adults and children. It is important to know the characteristics of young smokers to facilitate the creation and implementation of future programs for tobacco prevention.

Aim: The aim of this study was to determine the association between tobacco use and other lifestyle factors among schoolchildren in Tunisia.

Methods: We conducted a 2009/2010 cross-sectional questionnaire survey of 4003 randomly selected school children aged 13 years old (7th and 9th grades) to evaluate their knowledge, attitudes towards, and beliefs about the three risk factors for chronic disease (unhealthy diet, physical inactivity, and tobacco use). Written informed consent was obtained from each child’s parents who allowed their child to participate.

Results: The mean age of our sample was 13.36±1.28 years. The proportions of daily smokers were 2.2% and 0.1% among boys and girls, respectively. The proportions of irregular smokers were 9.1% and 1.5% among boys and girls, respectively. In our population, 19.1% (n=767) had ever experimented to smoke, with 29.8% among boys and 9% among girls (p<0.001). The proportions of schoolchildren who reported daily participation in physical activity were different between smokers and nonsmokers with 17.7% and 11.5%, respectively (p=0.03). Concerning eating habits, there was no significant difference in the consumption of fruits and vegetables; however, smokers frequently ate more high fat foods and in fast food restaurants. Similar results were found while comparing regular smoking children with those who experimented but who never became hooked on smoking.

Conclusion: This study and previous research suggest the importance of early intervention in adolescents on smoking and combing these efforts with interventions focusing on physical activity and dietary habits.

Keywords: risk factors; smoking habits; schoolchildren

References

  • 1.

    WHO report on the global tobacco epidemic (2008). The MPOWER package. Available at: www.who.int/tobacco/mpower/mpower_report_full_2008.pdf.

  • 2.

    Hamrouni M, Mokdad M. Le rapport de l’enquête nationale sur le tabagisme des jeunes scolarisés dans les écoles publiques, Mai 2007.

  • 3.

    OTAF en collaboration avec la LNC et l’UICC. Enquêtes sur la prévalence du tabac et le comportement des jeunes vis-à-vis du tabac dans les pays francophones.

  • 4.

    Ghannem H, Ben Abdelaziz A, Limam K, Gaha R, Ghedira A, et al. Tracking of cardiovascular risk factors among school children: a four-year population surveillance in Susa, Tunisia. Tunis Med 2005;83:404–8. [PubMed]

  • 5.

    Harrabi I, Maatoug J, Gaha M, Kebaili R, Gaha R, et al. School-based intervention to promote healthy lifestyles in Sousse, Tunisia. Indian J Community Med 2010;35:94–9. [Crossref]

  • 6.

    Larson NI, Story M, Perry CL, Neumark-Sztainer D, Hannan PJ. Are diet and physical activity patterns related to cigarette smoking in adolescents? Findings from Project EAT. Prev Chronic Dis 2007;4:A51.

  • 7.

    Peto R, Lopez AD, Boreham J, Thun M, Heath C Jr, et al. Mortality from smoking worldwide. Br Med Bull 1996;52:12–21. [Crossref] [PubMed]

  • 8.

    Wilson DB, Smith BN, Speizer IS, Bean MK, Mitchell KS, et al. Differences in food intake and exercise by smoking status in adolescents. Prev Med 2005;40:872–79. [PubMed] [Crossref]

  • 9.

    Schuit AJ, van Loon AJ, Tijhuis M, Ocke M. Clustering of lifestyle risk factors in a general adult population. Prev Med 2002;35:219–24 [Crossref]

  • 10.

    Silva DA, et al. Clustering of risk behaviors for chronic noncommunicable diseases: a population-based study in southern Brazil. Prev Med 2013;56:20–24. [Web of Science] [Crossref]

  • 11.

    Andersen LB, Wedderkopp N, Hansen HS, Cooper AR, Froberg K. Biological cardiovascular risk factors cluster in Danish children and adolescents: the European heart study. Prev Med 2003;37:363–67. [Crossref] [PubMed]

  • 12.

    Keski-Rahkonen A, Kaprio J, Rissanen A, Virkkunen M, Rose RJ. Breakfast skipping and health-compromising behaviors in adolescents and adults. Eur J Clin Nutr 2003;57:842–53. [Crossref]

  • 13.

    Baer Wilson D, Nietert PJ. Patterns of fruit, vegetable, and milk consumption among smoking and nonsmoking female teens. Am J Prev Med 2002;22:24046. [PubMed] [Crossref]

  • 14.

    Andersen LB, et al. Physical activity and clustered cardiovascular risk in children: a cross-sectional study (the European youth heart study). Lancet 2006;368:299304.

  • 15.

    Dumith SC, et al. Clustering of risk factors for chronic diseases among adolescents from Southern Brazil. Prev Med, 2012. [Web of Science] [PubMed]

  • 16.

    Paavola M, Vartiainen E, Haukkala A. Smoking, alcohol use, and physical activity: a 13-year longitudinal study ranging from adolescence into adulthood. J Adolesc Health 2004;35:238–44. [Crossref] [PubMed]

  • 17.

    Mackay J, Eriksen M, Shafey O. The tobacco atlas. 2nd ed. Atlanta, GA: American Cancer Society, 2006.

  • 18.

    Dupont P, Reynaud M. Adolescents and tobacco. EMC 37-213-B-35.

  • 19.

    Ministère de la Santé Publique. Santé des adolescents scolarisés: Résultats d’une enquête nationale. Direction de la médecine scolaire et universitaire 2002.

  • 20.

    Maatoug J, Harrabi I, Gaha R, Bouyahia O, Gaha M, et al. Etude d’intervention sur le tabagisme chez les adolescents dans la région de Sousse, Tunisie. Rev Pneumol Clin 2010;66:17986. [Crossref]

  • 21.

    Audrain-McGovern J, Rodriguez D, Tercyak KP, Cuevas J, Rodgers K, et al. Identifying and characterizing adolescent smoking trajectories. Cancer Epidemiol Biomarkers Prev 2004;13:202334.

  • 22.

    Kerjean J, Delbarre AS. Les adolescents et le tabac. Journal de pédiatrie et de puériculture 2005;18:389393.

  • 23.

    Collins LM, Graham JW. The effect of the timing and spacing of observations in longitudinal studies of tobacco and other drug use: temporal design considerations. Drug Alcohol Depend 2002;68(Suppl 1):S85–96. [Crossref]

  • 24.

    White HR, Pandina RJ, Chen PH. Developmental trajectories of cigarette use from early adolescence into young adulthood. Drug Alcohol Depend 2002;65:167–78. [Crossref] [PubMed] [Web of Science]

  • 25.

    Barreto SM, Giatti L, Casado L, de Moura L, Crespo C, et al. Smoking exposure among school children in Brazil. Science and Public Health 2010;15(Supl 2):30273034.

  • 26.

    Larson NI, Story M, Perry CL, Neumark-Sztainer D, Hannan PJ. Are diet and physical activity patterns related to cigarette smoking in adolescents? Project EAT. Preventing Chronic Disease: Public Health Research, Practice and Policy 2007;4.

  • 27.

    Pate RR, Trost SG, Levin S, Dowda M. Sports participation and health-related behaviors among US youth. Arch Pediatr Adolesc Med 2000;154:904–11.

  • 28.

    Kimm SY, Glynn NW, Obarzanek E, Kriska AM, Daniels SR, et al. Relation between the changes in physical activity and body-mass index during adolescence: a multicentre longitudinal study. Lancet 2005;366:301–7.

  • 29.

    Sjoberg A, Halberg L, Hoglund D, Hulthen L. Meal pattern, food choice, nutrient intake and lifestyle factors in The Goteborg Adolescence Study. Eur J Clin Nutr 2003;57:1569–78. [PubMed] [Crossref]

  • 30.

    Eisenberg ME, Olson RE, Neumark-Sztainer D, Story M, Bearinger LH. Correlations between family meals and psychosocial well-being among adolescents. Arch Pediatr Adolesc Med 2004;158:792–6.

  • 31.

    Yorulmaz F, Akturk Z, Dagdeviren N, Dalkilic A. Smoking among adolescents: relation to school success, socioeconomic status, nutrition, and self-esteem. Swiss Med Wkly 2002;132:449–54.

  • 32.

    Alamian A, Paradis G. Individual and social determinants of multiple chronic disease behavioral risk factors among youth. BMC Public Health 2012;12:224. [Crossref] [PubMed] [Web of Science]

About the article

Corresponding author: Asma Nouira, Department of Epidemiology, University Hospital Farhat Hached, Sousse, Tunisia, E-mail:


Received: 2013-03-09

Accepted: 2013-05-15

Published Online: 2013-07-26

Published in Print: 2014-05-01



Citation Information: International Journal of Adolescent Medicine and Health, ISSN (Online) 2191-0278, ISSN (Print) 0334-0139, DOI: https://doi.org/10.1515/ijamh-2013-0511. Export Citation

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