The 13th World Conference on Tobacco OR Health

Objective: Global School-Based Student Health Survey (GSHS) data were used to examine the association between tobacco use and other priority health risk behaviors among adolescents in 14 countries around the world. The GSHS was developed by WHO and other UN agencies with technical assistance from CDC to monitor health behaviors and protective factors among adolescents and to help countries develop priorities, establish programs, and advocate for resources for school health and youth health programs.

Methods: For each GSHS, a representative, two-stage cluster sample of schools containing the grades that 13-15 year olds attend was selected with probability to school enrollment to participate. Within each school, classes were randomly selected and all students in those classes were eligible to complete the survey. Students completed a self-administered questionnaire. Student response rates averaged 89%, school response rates averaged 97%, and overall response rates averaged 87%. The average sample size was 2568.

Results: Across GSHS sites, current cigarette use among 13-15 year olds students ranged from 3.5% (Hangzhou, China) to 29.8% (Metropolitan Region, Chile). Among current cigarette users, rates of current alcohol use, ever having been drunk, overweight, suicide ideation, loneliness, physical activity, sexual activity, parental monitoring, school absence, physical fighting, and bullying varied overall and by gender and GSHS sites. While adolescent tobacco use is a serious public health problem, for many adolescents around the world it is just one of many health risk behaviors that they practice.