Determinants of cigarette smoking among school adolescents in eastern Ethiopia: a cross-sectional study

Background: The World Health Organization (WHO) attributes more than 4 million deaths a year to tobacco, and it is expected that this figure will rise to 10 million deaths a year by 2020. Moreover, it is now a growing public health problem in the developing world. Objective: To assess the prevalence of cigarette use and its determinant factors among high school students in eastern Ethiopia. Methods: A cross-sectional study was conducted using structured self-administered questionnaires among 1,721 school adolescents in Harar town, eastern Ethiopia. Univariate and multivariate logistic regression analyses were performed to examine associations. Results: The analysis revealed that prevalence of ever cigarette smoking was 12.2% (95% CI 10.8% -13.9%). Reasons mentioned for smoking cigarettes were for enjoyment (113, 52.8%), for trial (92, 42.9%), and for other reasons (9, 4.3%). The main predictors of cigarette smoking were sex (OR 4.32; 95% CI 2.59-7.22), age (OR 1.20; 95% CI 1.05-1.38) and having friends who smoke (OR 8.14; 95% CI 5.19-12.70). Living with people who smoke cigarettes was not significantly associated with smoking among adolescents (OR 1.25; 95% CI 0.81-1.92). Conclusion: This study concluded that high proportion of school adolescents in Harar town smoked cigarettes. Sex, age and peer influence were identified as important determinants of smoking. There is a need for early cost-effective interventions and education campaigns that target secondary school students.