Determinants of adolescents' (11-17 years) support for smoke-free policies globally

Background: While smoke-free policies (SFPs) gain importance in developed countries, developing countries lag behind, especially in reducing smoking among adolescents. This research study delineates the determinants of adolescents' support for SFPs in the Global Youth Tobacco Survey (GYTS), which addresses the issue. Methods: A multivariate logistic regression analysis was conducted to analyze the GYTS data collected from youth aged 11-17 years (1999-2007). The analysis examined relationships between support for SFPs and individual measures related to smoking status, parental and peer smoking, exposure to secondhand smoke (SHS) and tobacco promotions, controlling for demographic factors. Results: Approximately 74% of 1,259,765 youth favored SFPs. The support for SFPs significantly increased by being an ever-smoker (OR 1.08, 95% CI 1.07-1.10), having knowledge about smoke harm (OR 2.60, 95% CI 2.58-2.63), exposed to smoking in and around homes (OR 1.16, 95% CI 1.14-1.17) and countermarketing (OR 1.02, 95% 1.01-1.03), and school anti-smoking curriculum (OR 1.49, 95% 1.47-1.51). Current smoking (OR 0.39, 95% CI 0.38-0.40), susceptibility to peer smoking (OR 0.52, 95% CI 0.51-0.53) and exposure to tobacco promotions (OR 0.72. 95% CI 0.701-0.73) were negatively associated. Conclusions: Findings suggest that while education about effects of tobacco use and exposure to SHS should be integrated into school curricula, compliance with SFPs by adolescents around the world could be enhanced when they are favored by them, which could be elicited by an environment where smoking among boys and girls is less attractive and socially acceptable, and also restricting or prohibiting tobacco industry advertising and promotions.