Prevalence and correlates of tobacco use among school-going adolescents in Madagascar

Sreenivas P. Veeranki, Hadii M. Mamudu, Rijo M. John, Ahmed E.O. Ouma

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Approximately 90% of adults start smoking during adolescence, with limited studies conducted in low-and-middle-income countries where over 80% of global tobacco users reside. The study aims to estimate prevalence and identify predictors associated with adolescents' tobacco use in Madagascar. We utilized tobacco-related information of 1184 school-going adolescents aged 13-15 years, representing a total of 296,111 youth from the 2008 Madagascar Global Youth Tobacco Survey to determine the prevalence of tobacco use. Gender-wise multivariable logistic regression models were conducted to identify key predictors.Approximately 19% (30.7% males; 10.2% females) of adolescents currently smoke cigarettes, and 7% (8.5% males and 5.8% females) currently use non-cigarette tobacco products. Regardless of sex, peer smoking behavior was significantly associated with increased tobacco use among adolescents. In addition, exposures to tobacco industry promotions, secondhand smoke (SHS) and anti-smoking media messages were associated with tobacco use. The strong gender gap in the use of non-cigarette tobacco products, and the role of peer smoking and industry promotions in adolescent females' tobacco use should be of major advocacy and policy concern. A comprehensive tobacco control program integrating parental and peer education, creating social norms, and ban on promotions is necessary to reduce adolescents' tobacco use.

Original languageEnglish (US)
Pages (from-to)239-247
Number of pages9
JournalJournal of Epidemiology and Global Health
Issue number3
StatePublished - Sep 1 2015
Externally publishedYes


  • Adolescents
  • Africa
  • Low- and middle-income countries
  • Madagascar
  • Tobacco control
  • Tobacco use

ASJC Scopus subject areas

  • Epidemiology


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