Changes in tobacco use and exposure to second hand smoke among students in selected countries of the africa: Findings from nationally representative global youth tobacco survey

Background: Tobacco use is the leading preventable cause of premature disease and death globally. Systematically monitoring tobacco use is a key strategy to address this epidemic. However, representative data on tobacco use has been particularly scarce from the African region. This study examines trends for current tobacco use and second hand smoke (SHS) exposure among students in selected African countries (Congo, Ghana, Lesotho, Namibia, South Africa, Swaziland and Uganda) using the Global Youth Tobacco Survey (GYTS). Methods: The GYTS, a self-administered school-based survey, has been conducted nationally in these African countries at least twice between 2002 and 2011 to monitor tobacco use and key tobacco control measures among students aged 13-15 years. Results: Namibia showed significant reduction in current cigarette smoking from18.8% to 11.9% and never smokers susceptible to initiate smoking from 36.4% to 24.9% but a large increase in other tobacco use from 15.0% to 26.4%. Four other countries also found smaller declines in current cigarette smoking or SHS exposure but increases in other tobacco use. South Africa showed a decline in both current cigarette smoking and other tobacco use. Conclusions: These findings indicate that decreasing cigarette smoking with concurrent increases in non-cigarette tobacco use in majority of the selected African countries, suggesting continued monitoring is important to understand trends and keep the tobacco epidemic in check. The effective implementation of prevention policies outlined in the World Health Organization Framework Convention on Tobacco Control and MPOWER have the potential to further reduce tobacco use and SHS exposure in Africa.