Gender differences in use of cigarette and non-cigarette tobacco products among adolescents aged 13-15 years in 20 African countries

Israel T Agaku; Rose Sulentic; Adriana Dragicevic; Gibril Njie; Candace K Jones; Satomi Odani; Tina Tsafa; Joy Gwar; Constantine I Vardavas; Olalekan Ayo-Yusuf

doi:10.18332/tid/169753

Gender differences in use of cigarette and non-cigarette tobacco products among adolescents aged 13-15 years in 20 African countries

Tob Induc Dis. 2024 Jan 22:22. doi: 10.18332/tid/169753. eCollection 2024.

Authors

Affiliations

¹ School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa.
² Centers for Disease Control and Prevention Foundation, Atlanta, United States.
³ Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, United States.
⁴ Osaka International Cancer Institute, Cancer Control Center, Osaka, Japan.
⁵ Department of Mass Communication, Benue State University, Makurdi, Nigeria.
⁶ Department of Clinical Psychology, Federal Medical Centre Makurdi, Makurdi, Nigeria.
⁷ Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, United States.

Abstract

Introduction: Examining gender differences in youth tobacco use is important as it aligns tobacco control within the context of broader human development goals seeking to eliminate gender inequalities. In this study, we examined gender differences in adolescent use of cigarettes, smokeless tobacco, shisha, and e-cigarettes in Africa.

Methods: This was a cross-sectional study using data from the Global Youth Tobacco Survey. Our analytical sample comprised 56442 adolescents aged 13-15 years from 20 African countries. Weighted, country-specific prevalence estimates were computed overall and by gender. Adjusted prevalence ratios (APRs) were calculated in a multivariable Poisson regression model to examine whether correlates of tobacco use differed between boys and girls.

Results: Ever cigarette smoking prevalence was significantly higher among boys than girls in 16 of the 20 countries, but a significantly higher percentage of girls reported earlier age of cigarette smoking initiation than boys within pooled analysis. Some of the largest gender differences in current cigarette smoking were seen in Algeria (12.2% vs 0.8%, boys and girls, respectively), Mauritius (21.2% vs 6.6%), and Madagascar (15.0% vs 4.1%). Current use of e-cigarettes, shisha, and smokeless tobacco was generally comparable between boys and girls where data existed. Among girls, higher levels of reported exposure to tobacco advertisement were positively associated with shisha smoking whereas perceived tobacco harm was inversely associated with current cigarette and shisha smoking. Among boys, perceived social acceptability of smoking at parties was associated with an increased likelihood of cigarette smoking (APR=2.27; 95% Cl: 1.20-4.30).

Conclusions: The prevalence of cigarette smoking among boys was higher than that of girls in many countries. However, girls who smoke tend to start at an earlier age than boys. Differential gender patterns of cigarette and non-cigarette tobacco product use among youth may have implications for future disease burden. As the tobacco control landscape evolves, tobacco prevention efforts should focus on all tobacco products, not just cigarettes.

Keywords: cigarettes; e-cigarettes; novel tobacco products; policy; tobacco.

Grants and funding

FUNDING Financial support for this study was provided through the CDC Foundation with grants from the Bill and Melinda Gates Foundation and Bloomberg Philanthropies. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.