A Cross Country Comparison of Tobacco Use Among Youth in Yerevan, Armenia and New Delhi, India

Abstract

Introduction: Tobacco use is one of the major preventable causes of death. Smoking rates among men in Armenia have been consistently high, being one of the highest rates among men. In India tobacco smoke is responsible for half of all the cancers in men and quarter of all the cancers in women. With the GYTS having been conducted in both countries, a comparative secondary analysis of the data from cross-sectional GYTS surveys (in 2004 for Yerevan and 2001 for New Delhi) will identify differences and similarities in risk factors for smoking among youth that will inform and improve interventions to reduce smoking in these two countries and possibly in other countries. Method:s Data obtained from GYTS for both the cities were cleaned and edited and a new questionnaire codebook of 32 questions similar to core questionnaires as obtained for both the cities was conducted. Secondary data analysis was conducted by the student researcher. Frequencies, bivariate analyses and multivariate logistic regression analyses was conducted. Results: Regular smoking rates were higher in the earliest ages in New Delhi as compared to Yerevan, the increase in the rates were higher in Yerevan than New Delhi and thus the regular smoking rates were higher in Yerevan for older students. Percent of students in Yerevan who has at least one parent smoking is 68.6% as compared to 41.1% in New Delhi. Two-thirds (66.2%) of the students in Yerevan reporting that they would definitely or probably smoke if their best friend offered them a cigarette, whereas only 8.3% of the students in New Delhi would definitely or probably smoke a cigarette if they were offered by their best friend. Using multivariate logistic regression controlling 8 for confounders, having a smoking father, accepting and smoking a cigarette from a best friend, and encountering anti-smoking references in newspapers and magazines were all more likely in Yerevan than New Delhi. Whereas, having a family member discuss the harmful effects of smoking and encountering anti-smoking references on posters were more likely in New Delhi than in Yerevan. A logistic regression model with regular smoking vs. non–regular smoking as the outcome, city of residence (New Delhi vs. Yerevan) and smoking risk factors as covariates shows that having a smoking father, accepting and smoking a cigarette from a best friend, encountering anti-smoking references on posters and encountering anti-smoking references in newspapers and magazines were all more likely for regular smokers than non-regular smokers. Whereas, having a family member discuss the harmful effects of smoking were more likely in non-regular smokers vs. regular smokers. Conclusions: Students in Yerevan initiate smoking later than students in New Delhi. Smoking fathers are role model for their sons. Having family members discussed the harmful effects of tobacco and reducing peer pressure could potentially reduce regular smoking rates. Anti tobacco campaigns are noted in posters and in newspapers and magazines more by non-regular smoking youth than regular smoking youth. There remain unknown and unmeasured cultural and environmental factors that differ between Yerevan and New Delhi and are associated with smoking rates. Recommendations: Smoking fathers should be targeted in anti-tobacco campaigns implemented by Ministry of Health and Non Governmental Organizations as they are role model for their sons. Family members should be included in these campaigns to prepare them to conduct family discussions about the 9 dangers of smoking with their children. Anti-tobacco references on posters and in newspapers and magazines should target on non-regular smokers among students as they are more often noted by non-regular smokers. More studies need to be conducted to explore unknown and unmeasured cultural and environmental factors that are associated with smoking rates.