Environmental Violence and Smoking Behaviors among Non-Hispanic Caribbean State Island: Integrating Violence Approach in the Prevention Strategies of Chronic Diseases using World Health Organization Data

Violence is a problem that affects global health and is a risk factor predisposing to other risky behaviors. Adolescents involved in violent environments are particularly vulnerable to risky behaviors such as smoking however violence is rarely integrated in smoking prevention programs. Objective: To examine the associations between exposure to violence and smoking behaviors among a sample of adolescents between 11 and 16 years in four Caribbean State-Islands that participated in the WHO Global School-based Student Health Survey in 2007. Methods: In a cross-sectional analysis of data from Trinidad & Tobago, Saint Lucia, Caiman Islands, and Vincent Islands we compared the relative frequency of violence among adolescents students who did/ or did not report exposure to violence. We estimated OR [95% CIs] for such behaviors adjusting for age and sex. Results: Age and sex were significantly associated to smoking behaviors (p value < 0.01). Having a violent event was also significantly associated to starting smoking age in all islands but Caiman Islands (p value < 0.01). However, having violent events were not associated to the intention of quitting smoking (p value > 0.05). Additional analysis also shows that violent environments are associated to smoking behaviors. Conclusions: Worldwide the number of smokers are increasing counting for more than 1.1 million persons. Health programs, rarely integrate violence prevention as a strategy to decrease smoking rates. Working with violent events could reduce the risk of engaging smoking behaviors, preventing the risk of multiple cancers, heart disease, strokes, emphysema and other fatal and non-fatal diseases.