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Stories of Discovery. Milestones in Cancer Research and Discovery. Biomedical Citizen Science. Director's Message. Prats-Uribe, Xie [ 13 ] found no difference in mortality rate between young smokers and non-smokers was noted.
There is lack of studies on long-term illness and impact of smoking on recoveries of illness from COVID, nevertheless, the higher risk of young smokers of been medically vulnerable, the medical policy intervention to address smoking among young smokers is likely to decrease their medical vulnerability to severe illnesses.
Numerous studies have examined the factors contributing to smoking adaptation behaviour globally. Andrea, Walter [ 15 ] in a study of Tuscan student nurses noted that a decrease in the availability of money, increase in the level of education, awareness of the harmful effects of tobacco smoking effectively contributed to a reduction in smoking among student nurses in Tuscany.
Similarly, Biraghi and Tortorano [ 16 ] in a study of nursing students at the University of Milan noted that the smoking habits of parents, siblings and friends were positively associated with smoking among the nursing students. Brenner and Scharrer [ 17 ] in a study of German medical students noted that maternal smoking was positively associated with smoking in students, while, paternal smoking behaviour and education background of the parents had no association with smoking in students.
Dursun, Cesur [ 18 ] noted no association between increased levels of education and smoking behaviours in students in Turkey for both genders. In contrast, Kilic and Ozturk [ 19 ] noted a positive association between female education and smoking in Turkey since females became more independent with higher education. Ling, Neilands [ 20 ] in a study of the behaviour of young adult smoking behaviour in the United States of America noted that while education was negatively associated with smoking, however, exposure to smoking and tobacco smoking was positively associated with smoking among the young adults in the US.
While the determinants of smoking behaviour are extensively researched, however, there is a lack of studies specific to small Pacific Island countries. Considering the conclusive evidence of factors that contribute to tobacco smoking, a country-specific study in the Pacific Island countries will provide insight on attributes that contribute to tobacco smoking in the region and will suggest policy measures that can be adopted by small island developing economies to discourage students from smoking.
This study examines the behavioural factors that contribute to the adoption of cigarette smoking in Samoa using the Global Youth Tobacco Survey data, available from the World Health Organization. After accounting for missing data from the survey, a total of 1, observations were utilised for estimation purposes in Stata.
This paper is structured as follows. Section 2 provides a brief description of the materials, data, and estimation procedures, followed by section 3 discussing the major findings and lastly, section 4 concludes with major findings and policy recommendations.
The study utilises data from Global Youth Tobacco Survey GYTS to investigate the leading and influential factors behind tobacco smoking adoption behaviour among youths in Samoa. The GYTS is a self-administered school-based survey designed to collect data and monitor tobacco use among the youths to devise and implement tobacco control and prevention programmes [ 21 ]. The survey had an overall response rate of Table 1 presents the descriptive summary of socio-economic and demographic variables for tobacco smoking among youths.
The overall survey response was made up of For the purpose of this study, smoking is defined as a student who tried or experimented with cigarette smoking, even one or two puffs.
A score of 1 is given to student who tried or experimented with cigarette smoking, even one or two puffs, 0 otherwise. Finally, we used multinomial logistic regression to measure and investigate factors influencing the attitude towards smoking among the students in the small Pacific Island Country of Samoa. However, a more convenient form of estimating logit regression is the logarithm of odds which estimates the logistic transformation of the probability of success.
By taking the exponential of the logit coefficient, we computed the odds ratio. The odds are the ratio is the probability of smoking to the probability of not smoking.
An odds ratio is the ratio of two odds. When the value of the odds ratio is higher than 1, it implies that the odds of success or an event taking place increases for one unit increase in the explanatory variable. Similarly, when the value of the odds ratio is less than 1, it implies that the odds of success or an event taking place decreases for one unit increase in the explanatory variable A odds ratio equal to 1 implies that there is no association between odds of success and explanatory variable.
The regression analysis was carried out using Stata software. The estimated result using the multinomial logistic regression is provided in Table 2. We noted that factors such as smoking among teachers in schools and media have no statistical impact on smoking behaviour among school students in Samoa. Overall, spending capacity and money on hand to some extent had a significant impact on tobacco smoking.
This indicates that a certain threshold level of pocket money is needed to motivate students to smoke. Similarly, we did not find any significant difference between the odds of smoking between a student with no money and a student with highest level of pocket money. This result is not surprising given that a student who does not have the pocket money do not have the means to buy smoke, while a student with too much pocket money can afford a better alternative form of pleasure to smoking.
Students with too much pocket money can also reflect a better socio-economic background and hence are less likely to indulge in smoking.
Furthermore, the age of students is also statistically significant in explaining smoking behaviour among students. With a one-year increase in age, the odds of smoking among students increases by 1. This indicates that more students are likely to try out smoking as they get older. This result is within expectation and in line with the findings from other studies. This result is consistent with Chen and Millar [ 25 ] in the context of Canada who found that age plays a critical indicator for the adoption of smoking habits among adults and with increasing age, cigarette consumption becomes more prevalent.
The odds of a male student smoking in Samoa is 2. This is as expected since the smoking prevalence among the male population in Samoa is significantly higher compared to females in all age groups [ 26 ]. Concerning peer influence, we observed that students are more likely to initiate smoking if their close friends also indulge in smoking. In the survey, students were asked to respond whether their friends smoked in the order: none of them, some of them, most of them and all of them, where for analysis purposes, none of them was chosen as the reference level.
According to the results, the odds of a student trying to smoke when some of their friends smoked were 3. Further, the odds of a student smoking if most of their friends or all their friends smoked were 2. This result indicates that friends, especially close friends are one of the major influencers and peer pressure groups towards trying or experimenting with tobacco smoking, which eventually leads to addiction after some time.
The findings further indicate that when most of the friends smoke, they are likely to pressure non-smokers to take up smoking. This result is similar to study findings from Greece [ 27 ], Ethiopia [ 28 ] and Bangladesh [ 29 ]. Pacific islanders have a culture of sharing cigarettes and with more friends smoking, it reduces the financial burden as the cost of tobacco and cigarettes are shared among a larger group of students.
The odds of a student smoking are 1. Mother with tertiary education level qualification side has insignificant effects on whether the student has tried or experimented with tobacco smoking. The result indicates that mothers with a secondary or vocational level qualification are more likely to engage in labour intensive and tedious occupation and therefore are less likely to spend quality time with their children, while mothers with primary education are more likely to stay home and have quality time with children.
On the other hand, mothers with tertiary qualification have better education and occupation to be able to spend quality time with children and educate on the harmful effects of tobacco smoking. The odds of a student smoking whose father smoked were 1.
However, smoking among both parents and only among mothers is found to be insignificant at a 5 percent significance level. The results overall show that students see fathers as the role model and major influencer in their teenage and youth years and have a higher probability of adopting his habits such as smoking tobacco, similar to findings from Stanton, Papandonatos [ 30 ].
Furthermore, we noted that discussion within families on the harmful effects of smoking has a negative relationship with tobacco smoking adoption among students.
We observed that the odds of a student smoking whose parents had earlier discussed the harmful effects of smoking within the family was only 0. This implies that raising more awareness among the parents on the harmful effects of smoking and encouraging them to discuss with their children is likely to reduce the tobacco smoking adoption among students in Samoa.
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