Global Youth Tobacco Survey - Bulgaria Prevalence, knowledge and attitudes to smoking

The Global Youth Tobacco Survey (GYTS) was conducted in Bulgaria in 2002 as part of an international surveillance project initiated by the World Health Organization/Tobacco Free Initiative, US Centres for Disease Control and Prevention and other partners. GYTS was designed to track the tobacco consumption among youth in countries across the world, using a common standardized methodology and protocol for data collection, which facilitates and permits evaluation, monitoring and data comparison across countries. OBJECTIVE To assess the active and passive smoking patterns of Bulgarian adolescents, as well as their knowledge, attitudes and beliefs about tobacco use, within the framework of GYTS-Bulgaria. METHOD GYTS-Bulgaria is a cross-sectional self-administered, school-based survey of a nationally representative sample of students from 7th, 8th and 9th grades with 2,167 students, aged 13-16 years completing the survey (1,008 males and 1,136 females). The Bulgarian version of the GYTS multiple-choice questionnaire was used, which comprised 56 core questions and 4 supplemental questions. RESULTS Analysis of the questionnaires showed that 69.1% of the students have smoked cigarettes at some time and 37.4% are current active smokers. Two-thirds of these (63.6%) manifest a desire to quit smoking and 71.0% had tried to stop smoking during the previous year but were unsuccessful. The greater part of the all studied population passively exposed to smoke in their homes and public places, with current smokers significantly more likely to report exposure than those that never smoked (P<0.05). Despite their knowledge about the detrimental effects of active and passive smoking on health, twice fewer current smokers than those who never smoked express negative attitudes to smoking of others and think that smoking should be banned in public places (P<0.05). The perception of smoking-attractiveness for both genders is significantly higher for current smokers than for those that never smoked (P<0.05). Inversely, for 80.8-81.7% of the studied population, smoking is not related to the perception of popularity. CONCLUSIONS These results show that the tobacco consumption among Bulgarian youth is among the highest in the world and suggest that youth smoking is an important target for public policy. The data imply also the imperative need for programs aimed at preventing or delaying the onset of tobacco use, as well as for programs to help school children to stop smoking. Prevention strategies should involve not only the students themselves but their families, schools and social environment as well.