Prevalence of cigarette smoking and other tobacco use among young people

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2. Knowledge and attitudes of young people towards cigarette smoking

hese questions measure general knowledge, attitudes, and intentions, which research has linked to the risk of smoking initiation and transitions toward more regular smok- ing. Several concepts are specifically addressed including susceptibility to smoking, which is a measure of how firm a never-smoker is regarding hisher intention to remain a non-smoker. Parental involvement, attitudes toward the perceived social benefits of smoking, knowledge and attitudes toward risks of tobacco use, and impact of peer pressure to use tobacco are also specifically addressed. he questions deline- ate: •฀ he strength of intention to remain non-smokers among young people who never smoked index of susceptibility •฀ What young people perceive as the social benefits and the health risks of smoking cigarettes •฀ he extent of peer pressure on young people to begin cigarette smoking

3. Role of the media and advertising in young people’s use of cigarettes

hese questions measure the exposure of young people to both pro- and anti-tobac- co use messages in the mass media. Pro-use messages: hese are messages that promote tobacco use. Children buy the most heavily advertised brands and are much more affected by advertising than are adults. he average youth already has been exposed to billions of dollars in imagery advertising and promotions creating a “friendly familiarity” for tobacco products–an environment in which smoking is seen as glamorous, social and normative. Young people are able to recall virtually no anti-smoking messages on television or in the movies, yet they are able to recall specific movies that portray smoking and are able to identify actors and actresses who smoke in their entertainment roles. Anti-use messages: An intensive mass media campaign can produce significant declines in both adult and youth smoking. It demonstrates that comprehensive edu- cation efforts, combining media, school-based, and community-based activities can postpone or prevent smoking onset in adolescents. he questions under this domain look at: •฀ How receptive young people are to cigarette advertising and other activities that promote cigarette use •฀ How aware and exposed young people are to anti-smoking messages

4. Access to cigarettes

Many countries have passed laws banning the sale of cigarettes to young people below certain ages 15 and 18 are the most common. hese questions measure the extent to which young people are able to purchase cigarettes in stores and whether they are asked to show proof of age. In addition, a series of questions have been added to determine the percent of disposable income available to young people that is spent on cigarettes. he questions in this series explore: •฀ Where young people usually get their cigarettes •฀ Whether sellers refuse to sell young people cigarettes because of their age •฀ How much money young people spend on cigarettes 233

5. Tobacco-related school curriculum

hese questions measure student perception of tobacco-use prevention education. Schools are an ideal setting in which to provide tobacco-use prevention education. School-based tobacco prevention education programmes that focus on skills train- ing have proven effective in reducing the onset of smoking. he questions under this topic look at: •฀ What young people are taught in school about tobacco •฀ Young people’s perceptions of their school’s programmes to prevent cigarette use

6. Environmental tobacco smoke ETS

hese questions measure exposure to second-hand tobacco smoke or environmen- tal tobacco smoke ETS. Since ETS is a significant risk factor for lung cancer, heart disease, asthma exacerbation and induction, respiratory infections, and adverse repro- ductive outcomes, it is important to assess exposure in youth. he questions in this section measure exposure during the past seven days and assess general knowledge or attitude about the harmful effects of ETS, including: •฀ he extent of young people’s exposure to smoking at home and in public places •฀ Young people’s perceptions of the harmful effects of ETS

7. Cessation of cigarette smoking

Many smokers, including youth, are addicted to nicotine and need assistance in quitting. Recently, there has been an increased demand for cessation programmes for youth. A primary reason for this increased demand is the recognition that many young tobacco users are interested in quitting and that they frequently try to quit but are mostly unsuccessful. To monitor the potential impact of tobacco control policies and diversion and cessation programmes it is important to measure: •฀ he short- and long-term likelihood that young cigarette smokers will quit GYTS฀sample฀selection he quality and usefulness of results from the GYTS depends largely on the proce- dures used to select the participating schools, classes sections and students. Because surveying every student is impossible, impractical and unnecessary, a sample of the population is selected. he results from a good sample can be generalized to the entire student population from which the sample is drawn. he results from a poor sample only refer to students who participate. he following describes the two-stage sample design used for the GYTS: STAGE 1: Selection of schools he target population for the GYTS is youth in grades associated with ages 13–15 years. Each country compiles a list of schools, which include grades forms, levels, secondaryies, or standards associated with these ages. he schools are selected with probability proportional to enrolment size PPE. his means that large schools are more likely to be selected than small schools. he number of schools to select is dependent on both statistical and practical con- siderations. Statistically, the number of schools selected can affect the precision of the