Prevalence of tobacco use and associated factors among teenage pupils in Madagascar

The available data on the prevalence of tobacco use among teenagers in Madagascar are very limited. The aim of this study was to analyze tobacco-use behaviors among teenage pupils aged 12 to 18 living in urban and suburban areas of Madagascar and to identify the associated risk factors. A cross-sectional descriptive study was conducted as part of this research. Probabilistic multistage sampling was used to obtain a representative sample. Data were collected using an anonymous self-reported questionnaire and computer analyzed using SPSS 16. Correlation and logistic regression were used to analyze the risk factors. The results show that approximately one third of the 711 pupils (36.3%) included in the sample reported that they had tried tobacco. Among them, 25.2% were regular users. Nearly 10% had started smoking before the age of 14. Male adolescents were found to smoke twice as much as their female counterparts. The study found that the key factors associated with tobacco use include: male gender (Exp(B)=3,769(95%IC 2,579-5,509), urbanization (Exp(B) = 3,679, 95% IC 2,138-6,332), age, peer influence, a sense of insecurity at school, and the impact of the mass media (films, television). The study found that the family environment did not have a significant impact on tobacco use. To conclude, the prevalence of smoking among teenage pupils in Madagascar is a significant issue. This paper argues that it is important to understand the associated risk factors in order to develop a prevention program aimed at reversing the tobacco epidemic in schools.