Changes in Tobacco Use Among Youths Aged 13--15 Years --- Panama, 2002 and 2008
Tobacco use is the single most preventable cause of death in the world today (1), and the majority of
Changes in Tobacco Use Among Youths Aged 13--15 Years --- Panama, 2002 and 2008
Tobacco use is the single most preventable cause of death in the world today (1), and the majority of smokers begin using tobacco products before age 18 years (2). However, before the late 1990s, few countries had reliable data on youth tobacco use. In 1999, the World Health Organization (WHO), CDC, and the Canadian Public Health Association developed the Global Youth Tobacco Survey (GYTS) to help countries monitor youth tobacco use (3). At the same time, WHO initiated the Framework Convention on Tobacco Control (WHO FCTC), the first international public health treaty on tobacco control (4). Panama ratified WHO FCTC in 2004 and enacted two key antitobacco regulations in 2005 and 2008. To evaluate progress toward attaining tobacco control goals in Panama, Panama's Ministry of Health, CDC, and WHO compared results from GYTS surveys conducted in Panama in 2002 and 2008. This report summarizes the results of that comparison, which revealed substantial decreases from 2002 to 2008 in youth current cigarette smoking (13.2% versus 4.3%), current use of tobacco products other than cigarettes (9.8% versus 5.8%), and likely initiation of smoking by never smokers (13.8% versus 10.0%). In addition, factors influencing tobacco use showed substantial decreases, including 1) exposure to secondhand smoke (SHS) at home and in public places, 2) best friends smoking, 3) protobacco advertising in newspapers and magazines, and 4) having an object with a tobacco company logo on it. These results suggest that comprehensive regulations in Panama helped reduce tobacco use among adolescents and further gains are possible.
GYTS is a school-based survey that collects data from students aged 13--15 years and has been completed in 163 countries, with repeat surveys in 100 countries. GYTS uses a two-stage cluster sample design that produces representative samples of students in grades associated with students aged 13--15 years (3). GYTS uses a standardized methodology for constructing sampling frames, selecting schools and classes, preparing questionnaires, conducting field procedures, and processing data. At the first stage, the probability of schools being selected is proportional to the number of students enrolled in the specific grades. At the second sampling stage, classes within the selected schools are randomly selected. All enrolled students in selected classes the day the survey is administered are eligible to participate. Student participation is voluntary and kept anonymous by using self-administered data collection procedures.
GYTS was conducted in Panama in 2002 and 2008. In both years, GYTS sampling included all public and private schools with grades 8--10. In 2002, a total of 2,017 students completed the Panama GYTS from 50 selected schools. Of these students, 1,296 indicated that they were aged 13--15 years. In 2008, a total of 3,534 students completed the Panama GYTS from 50 selected schools, of whom 2,716 indicated that they were aged 13--15 years. The school response rate (number of participating schools divided by the number of selected schools) was 98.0% in 2002 and 96.0% in 2008; the class response rate (number of participating classes divided by the number of selected classes) was 100.0% in 2002 and 99.3% in 2008; the student response rate (number of participating students divided by the number of students enrolled in the class) was 89.1% in 2002 and 83.9% in 2008; and the overall response rate (product of the school response rate, the class response rate, and the student response rate) was 87.3% and 80.0%, respectively.
This report summarizes the results from 10 key GYTS tobacco-use indicators: 1) current cigarette smoking; 2) current use of tobacco products other than cigarettes; 3) likely initiation of cigarette smoking in the next year among never smokers (i.e., susceptibility) (5); 4) exposure to SHS at home and in public places; 5) one or more best friends smoke cigarettes; 6) in favor of banning cigarette smoking in public places; 7) exposure to protobacco advertising in newspapers and magazines, having protobacco promotional items, having been offered free cigarettes, and exposure to antitobacco media messages; 8) am