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      Risk factors and prevalence of use of different tobacco products among school adolescents in the North Central region of Morocco: a cross-sectional study

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          Abstract

          Introduction

          The rising number of youth smokers is a major concern to public health in Morocco. The implementation of appropriate preventive measures would require information about the prevalence and determinants of tobacco use. Data on tobacco consumption among adolescents in the North Center of Morocco are scarce. Therefore, the current study aims at investigating the risk factors of smoking and the prevalence of the use of different forms of tobacco among school teenagers in the North-Centre region of Morocco.

          Methods

          A cross-sectional study was conducted in North Central Region of Morocco among students in public secondary schools selected by stratified cluster random sampling. The statistical unit devised was a school class from the seventh to the twelfth grade of the Moroccan educational system.

          Results

          A total of 3020 students (53% were males) and an average age = 16 ± 2.1 years were included in the study. The prevalence of the use of cigarettes was 16.1% (95% CI: 14.8% - 17.4%).For other tobacco types such as hookah, snuff and tobacco chewing, the prevalence was respectively 70.6%, 42.8% and 35.0% for cigarettes smokers. The level of current tobacco use was noticeably higher among boys (15.0% vs. 2.5%, p < 0,001) and high school students in comparison to middle school pupils (21.2% versus 11.9%; p < 0,001).

          Conclusion

          Among young people, all types of smoking are growing increasingly in our Moroccan society; this alarming result can contribute to help the decision-makers to make decisions and force us obviously to take preventive measures rapidly.

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          Most cited references14

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          Psychosocial factors related to adolescent smoking: a critical review of the literature.

          To extend the analysis of psychosocial risk factors for smoking presented in the United States surgeon general's 1994 report on smoking and health, and to propose a theoretical frame of reference for understanding the development of smoking. General Science Index, Medline, PsycLIT, Sociofile, Sociological Abstracts, and Smoking and Health. Holdings of the Addiction Research Foundation of Ontario Library as well as the authors' personal files. Reviewed literature focused on studies that examined the association of sociodemographic, environmental, behavioural, and personal variables with smoking. Adolescent smoking was associated with age, ethnicity, family structure, parental socioeconomic status, personal income, parental smoking, parental attitudes, sibling smoking, peer smoking, peer attitudes and norms, family environment, attachment to family and friends, school factors, risk behaviours, lifestyle, stress, depression/distress, self-esteem, attitudes, and health concerns. It is unclear whether adolescent smoking is related to other psychosocial variables. Attempts should be made to use common definitions of outcome and predictor variables. Analyses should include multivariate and bivariate models, with some attempt in the multivariate models to test specific hypotheses. Future research should be theory driven and consider the range of possible factors, such as social, personal, economic, environmental, biological, and physiological influences, that may influence smoking behaviour. The apparent inconsistencies in relationships between parental socioeconomic status and adolescent disposable income need to be resolved as does the underlying constructs for which socioeconomic status is a proxy.
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            The report of the Surgeon General: preventing tobacco use among young people.

            This year's surgeon general's report on smoking and health is the first such report to focus on young people. From extensive data that indicate that tobacco use is a pediatric epidemic, the report reached six major conclusions: (1) Nearly all first use of tobacco occurs by age 18. (2) Most adolescent smokers are addicted to nicotine. (3) Tobacco is often the first drug used by young people who subsequently use illegal drugs. (4) There are identified psychosocial risk factors for the onset of tobacco use. (5) Cigarette advertising also appears to increase young people's risk of smoking. (6) Communitywide efforts have successfully reduced adolescent use of tobacco. This commentary restates each of the six conclusions, summarizes the data that support each, and then considers the implications of the conclusions for public health action.
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              Health-compromising behaviors: why do adolescents smoke or drink?: identifying underlying risk and protective factors.

              To better understand the motivation for adolescent smoking and drinking and to identify the underlying risk and protective factors associated with these behaviors among adolescents. Cross-sectional, school-based survey of students in grades 5 through 12. A nationally representative sample of 2574 boys and 2939 girls in grades 7 through 12 from 297 public, private, and parochial schools across the United States who participated in The Commonwealth Fund Survey of the Health of Adolescent Girls and Boys in 1997. Sex-specific adjusted relative risks (RRs) and 95% confidence intervals (CIs) comparing self-reported regular smokers and regular drinkers by risk and protective factors with adolescents reporting none of these behaviors. Adolescent boys and girls were equally likely to be regular smokers (11.2%). The prevalence rate of regular drinking was only slightly higher for boys (22.4%) than it was for girls (19.3%). The rates of both health-risk behaviors were significantly higher for those reporting risk factors, and the strengths of associations varied by sex. Sex differences also emerged in motivation for engaging in these behaviors. When we adjusted for demographic characteristics, exposure to childhood abuse (RR, 4.1; 95% CI, 2.4-7.0) and stressful life events (RR, 2.4; 95% CI, 1.1-5.4) were strongly associated with increased risk for boys' regular smoking. Similar associations were found for regular drinking. For girls, a history of abuse (RR, 1.8; 95% CI, 1.1-2.8), violence within the family (RR, 2.2; 95% CI, 1.6-3.2), depressive symptoms (RR, 1.6; 95% CI, 1.0-2.4), and stressful life events (RR, 3.1; 95% CI, 1.8-5.6) were significantly associated with increased risk for regular smoking. Similar associations were again found for regular drinking. Parental support was protective against both health-risk behaviors for both sexes. Participation in extracurricular activities was associated with lower risk for regular smoking for boys (RR, 0.4; 95% CI, 0.2-0.7) and for girls (RR, 0.3; 95% CI, 0.2-0.5); however, there was no significant association between drinking behavior and participation in activities. The increased risk for regular smoking and regular drinking among adolescents with a history of abuse, family violence, depressive symptoms, and stressful life events suggests that routine screening for abuse, violence, and other family experiences should be an essential component of adolescent health care visits. Effective prevention programs to reduce smoking and drinking among adolescents should recognize that health-risk behaviors may be associated with other negative life experiences and that the strength of these associations differs by sex.
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                Author and article information

                Journal
                Pan Afr Med J
                Pan Afr Med J
                PAMJ
                The Pan African Medical Journal
                The African Field Epidemiology Network
                1937-8688
                29 May 2018
                2018
                : 30
                : 73
                Affiliations
                [1 ]Laboratory of Epidemiology, Clinical Research and Health Community, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdallah University, Fez, Morocco
                [2 ]Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
                [3 ]Pneumology Service, Centre Hospitalier Universitaire Hassan II of Fez, University Sidi Mohamed Ben Abdellah, Fez, Morocco
                Author notes
                [& ]Corresponding author: Belkacem Bendaou, Laboratory of Physiology-Pharmacology and Environmental Health, Dhar El Mahraz Faculty of Sciences, Sidi Mohammed Ben Abdallah University, Fez, Morocco
                Article
                PAMJ-30-73
                10.11604/pamj.2018.30.73.10896
                6191258
                aa9a7ac1-a709-4b6c-a6b5-d0e0c30b7ebe
                © Belkacem Bendaou et al.

                The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 07 October 2016
                : 04 April 2018
                Categories
                Research

                Medicine
                tobacco,adolescence,school students,prevalence,risk factors,morocco
                Medicine
                tobacco, adolescence, school students, prevalence, risk factors, morocco

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