[Tobacco and marijuana use in adolescent students in Noumea]

Abstract

Introduction: New Caledonia is situated in the western South Pacific 20000 km from France. In this Overseas Territory (pays d'outre-mer [POM]) the prevalence of tobacco smoking is very high and estimated at 30% among men and 34% among women. Experimenting with cannabis is also very widespread. The incidence of chronic respiratory illness and lung cancer remains high in the Territory. Modern laws protecting non-smokers still do not exist. This study aims at describing the behaviour of young people from 14 to 18 years old, at school in the public sector of Noumea, with respect to tobacco and marijuana consumption. This survey examines the way this behaviour varies according to age, sex, community, place of residence and socioeconomic conditions, in order to identify the most exposed groups. Finally, we study the effect of this consumption on the respiratory health of young school people.

Methods: The enquiry was undertaken from May 4th to 15th 2009 in 16 classes drawn randomly from the colleges and secondary schools of Noumea (439 pupils). The survey consisted of an anonymous questionnaire containing 48 questions grouped into five subjects: a sociodemographic description of the subject and his/her family, the family lifestyle, tobacco consumption, marijuana consumption and a respiratory questionnaire. The completion of the questionnaires took, on average, 25 minutes and took place in class in the presence of the doctor undertaking the survey. The data were analysed with Ethnos-4 software. The analysis was made in two stages: a descriptive study after uni- and bivariate analysis and an analytical study to identify the risk factors of the addictive practices. The statistical tests used were Pearson's chi(2) test and the Hosmer-Lemeshow test for calculation of odds ratio.

Results: The participation rate was 95.2% (n = 415). The sample was predominantly female (56.6%) and 31% of the pupils were less than 16 years old. The number of tobacco smokers was considerable at 41.1%, 27.3% were regular daily smokers including 38.5% who smoked more than six cigarettes a day. The results were dependent on sex (female predominence) but independent of ethnic origin and socioeconomic factors. The number of cannabis smokers was 48% among whom 32% were regular consumers. The daily smokers were uniquely boys and the custom was more frequent among the Melanesian population. Only 11% of the pupils were worried about their consumption and, among them, only the regular smokers were more at risk of bronchial infection.

Conclusions: In New Caledonia, tobacco consumption levels are higher than those in developed countries. We did not find a falling trend compared with previous data. The use of cannabis remains very widespread at an early age, with a male predominance for daily consumption. For both, these addictions the perception of the risk and the desire to stop are weak. The population studied is representative of teenagers in the public sector schools in Grand-Noumea but probably does not reflect the situation on the whole territory. The results obtained suggest the value of a study of the whole of New Caledonia, the eventual purpose being to guide the public health authorities towards policies that help the young people of the country.