Prevalence and factors associated with current tobacco use among youth in Uganda: Results from the Global Youth Tobacco Survey 2011 Kadobera Daniel Tobacco Control Fellow Ministry of Health – Uganda RESEARCH CONFERENCE ON TOBACCO CONTROL IN AFRICA 16 th –18 th JULY 2014 CAPE TOWN SOUTH AFRICA

Introduction Tobacco use is the leading cause of premature death, disease and disability in the world. It causes an estimated 6 million preventable deaths annually. Curbing youth and early adult tobacco use can potentially have a major impact on reducing morbidity and mortality in older age groups

Uganda Profile Population; Million (2012) Sex ratio; 95 males per 100 females Life expectancy; 50.4 Years IMR; 54 deaths per 1000 Live births U5MR; 90 deaths per 1000 Live births TFR; 6.2 children per woman Source; UBOS 2012

Tobacco use is more common among Ugandan men than women (15% compared with 3%). 12% of men age smoke cigarettes, 1% smoke pipes and 4% consume other forms of tobacco. Use of tobacco is most common among older men, men living in rural areas, and those with no education. Source; UBOS 2012

Global Tobacco Surveillance System - GTSS Global Adult Tobacco Survey (GATS) Global Youth Tobacco Survey (GYTS) Global Health professional Survey (GHPS) Tobacco Questions for Surveys (TQS)

Methods GYTS is a school-based survey among students aged years. The questionnaire, sampling and implementation of field work are all standardized Two-stage cluster sample design to produce a representative sample of students aged years. A total of 50 schools participated in the survey. A total of 3,450 students participated in the survey with an overall response rate of 83.3%.

Results Overall current tobacco use among students was at 17.3%; 19.3% for males compared to 15.8% for females Current cigarette smoking was 4.8% overall, with 5.0% for male and 4.7% for female. Usage of other smoked tobacco products of 9.7% and use of smokeless tobacco of 10.0%.

21.6% was the estimated exposure to secondhand smoke at home, 26.3% exposed to SHS in enclosed public places while 38.3% reported exposure to SHS in outdoor public places in the last 7 days 49.2% favoured banning smoking in public places 61.5% believed smoke from other people is harmful 20.8% of the current tobacco users amongst the youth reported having one or more parents who smoke compared to 9.7% of non tobacco users. 5% of the current tobacco users among the youth reported having most of all friends who smoke compared to 1.9% of non tobacco users.

52.1% reported seeing cigarette advertisements on billboards, 46.5% in print media like newspapers and magazines. 11.3% reported owning something (t-shirts, pens, etc) bearing a cigarette brand or logo while 10.7% reported having been offered a free cigarette by a tobacco industry representative Having ever tried or experimented with one or two puffs was the strongest indicator (OR 10.4) of current tobacco use followed by having one or both parents who smoke (OR 1.9)

Implications Tobacco use among the youth is high and there is no gender difference in the tobacco use prevalence. Prevalence of other smoked tobacco (such as cigars and pipes) and smokeless tobacco products is substantial (unregulated). Evidence SHS exposure at home, in enclosed and outdoor public places despite the existence of government regulations on smoke-free environments

Tobacco advertising, promotion and sponsorship is active in Uganda, in the absence of any laws restricting these activities Direct advertising by the TI targeting youth with free cigarettes and items with tobacco logos

Limitations Data collection was limited to only youth attending school. There exists an effective ministerial directive banning advertisement which is effectively being complied with, as it is evident that billboards with tobacco adverts are now nonexistent. There is potential bias generated from self reporting

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