Tobacco use among high school students in a remote district of Arua, Uganda

Tobacco smoking is a risk factor for several non-communicable public health problems including cancer, ischaemic heart disease and chronic obstructive airways disease. The prevalence of smoking among adolescents and the associated environment deserve attention.

A cross-sectional descriptive study was carried out in 2001 to determine the prevalence of tobacco smoking, exposure to advertisements, environmental tobacco smoke exposure, deterrents from smoking and perception about smoking among high school students in a remote district of Arua, north-western Uganda.

In total 1528 high school students participated in the study of which 21.9% were current smokers and 33.1% had ever used tobacco products. When the data were stratified according to sex, 81/452 (17.9%) females and 337/871 (38.7%) males had ever smoked (p <0.05). With regard to current smoking, defined as having smoked at least once in the past 30 days, 12.2% of females (55/452) and 25.5% males were current smokers. Approximately one-tenth perceived themselves as likely to initiate smoking within the next 12 months. Just under half (47.3%) were exposed to environmental (passive) smoking in the home and 19.4% of current smokers usually smoked at home. Approximately 60% of smokers had obtained tobacco from grocery stores and they had never been prevented because of their age. Media exposure to tobacco advertisements was high.

Many young people in Arua, Uganda, were current smokers and exposed to environments that seemed to facilitate uptake of tobacco smoking and other tobacco use. This could be explained in part, by the fact that the district relies heavily on tobacco farming and exposure to facilitating environments is common. A concerted public health response is urgently required that will effectively alter the home and societal environment so as to discourage uptake of tobacco use by young people.