Prevalence, Risk Factors, and Intervention Approaches Related to Adolescent Smoking in Pakistan: A Scoping Review
Keywords:
Adolescents, Prevalence, Prevention approaches, Risk factors, Smoking BehaviorAbstract
The study aimed to explore prevalence, risk factors, and intervention approaches related to adolescent smoking in Pakistan. Databases included PubMed, Scopus, Embase, Google Scholar, and ProQuest. Studies were selected on Pakistani adolescents aged 10-21 years, original or secondary articles published in English, and the use of qualitative and quantitative methods. Out of 1300 articles, 300 duplicates were removed. After reviewing titles and abstracts, 980 records were excluded. The full text of the 18 remaining studies was reviewed based on inclusion criteria, with 13 eligible studies included. Data extraction included author, age, setting, design, sample, theory, prevalence, risk factors, findings, and appraisal. Ten eligible studies reported varying prevalence rates of adolescent smoking in Pakistan, ranging from 09% to 61.14%. Individual risk factors associated with smoking included disposition, mood, and substance abuse. Social risk factors included family and peer influences, including father's smoking status, family members' tobacco use, and peer pressure. Environmental risk factors, including attendance at a public school, school-related pressure, exposure to tobacco use on social media, and lower socioeconomic status, significantly increased the likelihood of smoking among adolescents. Three studies evaluating prevention and intervention approaches demonstrated positive outcomes, including increased awareness of smoking harms, attitude shifts, and increased intention to quit smoking. This scoping review identified the influence of individual, social, and environmental risk factors on adolescent smoking. Educational interventions showed positive results on knowledge and attitude; however, none specifically focused on smoking cessation. Future research should focus on addressing these risk factors and implementing theory-guided interventions.
Downloads
References
World Health Organization. The global tobacco epidemic 2019: offer help to quit tobacco use. Geneva: WHO [Internet]. 2019 Available from https://www.who. int/publications/i/item/9789241516204
World Health Organization. Global report on trends in prevalence of tobacco use 2000-2025. Geneva: WHO [Internet]. 2021. Cited 16 November 2021. Available from https://www.who.int/publications/ i/item/9789240 039322
World Health Organization. Tobacco [Internet] Ge-neva: World health organization; 2023.Updated 31 July 2023; cited 2023 Septmber 15. Available from: https://www. who.int/news-room/fact-sheets/detail/ tobacco.
National Heart L, & Blood Institute. Smoking and Your Heart - How Smoking Affects the Heart and Blood Vessels. United States: National Heart,Lung & Blood Institute; 2022. Updated March 24, 2022; cited 2023 Nov 1. Available from: https://www.nhlb i.nih.gov/health/ heart/smoking.
Jha P, Ramasundarahettige C, Landsman V, Rostron B, Thun M, Anderson RN, et al. 21st-Century hazards of smoking and benefits of cessation in the United States. N Engl J Med 2023; 368:341-50. doi:10.1056/NEJM SA1211128
National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2014. Available from https://www.ncbi.nlm.nih. gov/books/NBK179276/
Dai X, Gakidou E, Lopez AD. Evolution of the global smoking epidemic over the past half century: strengthening the evidence base for policy action. Tob Control 2022; 31:129-37. doi:10.1136/tobaccocontrol-2021-056535
Datta BK, Husain MJ, Nargis N. An Intertemporal Analy-sis of Post-FCTC Era Household Tobacco Consumption in Pakistan. Int J Environ Res Public Health 2019; 16:2532. doi:10.3390/ijerph161425322
Institute for Health Metrics and Evaluation. Global Burd-en of Disease USA: University of Washington; 2019.Cited 2023 October 25. Available from: https://vizhub.health data.org/gbd-compare/.
Zhang Q, Yu B, Chen X, Varma DS, Li J, Zhao J, et al. Patterns of smoking initiation during adolescence and young adulthood in South-West China: findings of the National Nutrition and Health Survey (2010–2012). BMJ Open 2018; 8:e019424. doi:10.1136/bmjopen-2017-019424
Nawi AM, Ismail R, Ibrahim F, Hassan MR, Manaf MR, et al. Risk and protective factors of drug abuse among adolescents: a systematic review. BMC Public Health 2021; 21:2088. doi:10.1186/s12889-021-11906-2
American Lung Association. Tobacco use among child- ren and teens Chicago, Illinois, United States: American lung association; 2023. Updated May 31, 2023; cited 2023 September 15. Available from: https://www.lung. org/quit-smoking/smoking-facts/tobacco-use-among-children.
Nazir MA, Al-Ansari A, Abbasi N, Almas K. Global prevalence of tobacco use in adolescents and its adverse oral health consequences. Open Access Maced J Med Sci 2019; 7:3659-66. doi:10.3889/oamjms.2019.542
Mangrio FA, Mangrio SA, Fatima M. Health Consequ-ences of Smokeless Tobacco Substance Abuse among High School Adolescents. J Fatima Jinnah Med Univ 2022; 16:185-8. doi:10.37018/PIUK9961
Dolah S, Mohd AM, Abd-ur-Rahman N. Towards healthy adolescents: a review of smoking impact according to dental perspectives. Mal J Med Health Sci 2023; 19:316-24. doi:10.47836/mjmhs19.1.40
Rohmi F, Nurbadriyah WD. The association between stress level and smoking behavior in gondanglegi junior high school boys. J Nurs Sci Upd 2022; 10:186-92.
Pakistan Global Youth Tobacco Survey. Global Youth Tobacco Survey (GYTS) Fact Sheet Pakistan. Genava: World Health Organization, 2013. Updated July 31, 2015; Available from https://extranet.who.int/ ncdsm-icrodata/index.php/catalog/?page=1&ps=15
Mishu MP, Siddiqui F, Shukla R, Kanaan M, Dogar O, Siddiqi K. Predictors of cigarette smoking, smokeless tobacco consumption, and use of both forms in adolescents in South Asia: A secondary analysis of the global youth tobacco surveys. Nicotine Tob Res 2021; 23:956-65. doi:10.1093/ntr/ntaa202
Rozi S, Akhtar S, Ali S, Khan J. Prevalence and factors associated with current smoking among high school adolescents in Karachi, Pakistan. Southeast Asian J Trop Med Public Health 2005; 36:498-504.
National Institute of Population Studies (NIPS) [Pakis-tan] and ICF. 2019. Pakistan Demographic and Health Survey 2017-18. Islamabad, Pakistan, and Rockville, Maryland, USA: NIPS and ICF. Available from https://dhsprogram.com/pubs/pdf/FR354/FR354
Latif Z, Jamshed J, Khan MM. Knowledge, attitude and practice of cigarette smoking among university students in Muzaffarabad, Pakistan: a cross-sectional study. Int J Sci Rep 2017; 3:240. doi:10.18203/issn.2454-2156.intjscirep20174089
The Toll of Tobacco in Pakistan. Tobacco Consumption. Washington, DC, United States of America.: Campaign for Tobacco-Free Kids; 2021. Updated Aug 3, 2021; cited 2023 Septmeber 30. Available from: https://www.toba ccofreekids.org/problem/toll-global/asia/pakistan
Chand B, Bhusal S, Pradhan PM, Paudel K, Adhikari N, Adhikari TB, et al. Tobacco use and its associated factors among undergraduate public health students in Kathmandu Valley, Nepal. J Environ Public Health 2022; 2022:1495779. doi:10.1155/2022/1495779
Todorovic I, Cheng F, Stojisavljevic S, Marinkovic S, Kremenovic S, Savic P, et al. Prevalence of cigarette smoking and influence of associated factors among students of the university of Banja Luka: A cross-sectional study. Medicina (Kaunas) 2022; 58:502. doi:10.3390/medicina58040502
Simplicio MP, Silva LB, Juvanho LL, Priore SE, Frances-chini SD. Factors associated with alcohol, tobacco and illicit drug use among Brazilian undergraduate students. Rev Bras Enferm 2021; 74:e20201244. doi: 10.1590/0034-7167-2020-1244
Bushra R, Aslam N, Bano UK, Jamal A, Baig AA, Sherwani SK. Prevalence of smoking in teenagers male undergraduate students a study of Karachi, Pakistan. Int J Basic Med Sci Pharm 2013;3: 49-51.
Lalithambigai G, Rao A, Rajesh G, Ramya S, Pai BH. Predictors of Cigarette Smoking among Young Adults in Mangalore, India. Asian Pac J Cancer Prev 2016; 17:45-50. doi:10.7314/apjcp.2016.17.1.45
Baheiraei A, Soltani F, Ebadi A, Foroushani AR, Cheraghi MA. Risk and protective profile of tobacco and alcohol use among Iranian adolescents: a population- based study. Int J Adolesc Med Health 2016;29. doi:10.1515/ijamh-2015-0089
Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (prisma-scr): checklist and explanation. Ann Intern Med 2018;169:467-73. doi:10.7326/m18-0850
Munn Z, Peters MD, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol 2018; 18:143. doi: 10.1186/s12874-018-0611-x
Joanna Briggs Institute. Checklist for Analytical Cross Sectional Studies Critical Appraisal Australia: Joanna Briggs Institute 2017; Updated 2020. Available from: http://joannabriggs.org/research/critical-appraisal-tools.htmlwww.joannabriggs.org
Joanna briggs institute. Checklist for quasi-experimental studies Australia: Joanna briggs institute 2020; Updated 2020; cited 2023 Nov 11. Available from: http:// joannabriggs.org/research/critical-appraisal-tools.htmlwww.joannabriggs.org
Tufanaru C MZAECJHL. Chapter 3: Systematic reviews of effectiveness. JBI Manual for Evidence Synthesis. 2020. doi:10.46658/JBIMES-20-04.
Ahmad A, Jafar K, Saddiqa A, Firdos U, Qadeer A. Prevalence and Determinants of Smoking among School Students at Rural Community, Lahore. Saudi J Nurs Health Care 2022; 5:308-20. doi:10.36348/sjnhc.2022.v05i12.002
Ahmed J, Taj T, Shaikh S, Ali S. Factors associated with tobacco smoking among 6-10 grade school students in an urban Taluka of Sindh. J Coll Physicians Surg Pak 2011; 21:662-5.
Laghari ZA, Halepota J, Palh ZA, Lashari KH, Baig NM, Menghwar SM, et al. Factors associated with cigarette smoking among male students of colleges of district, Hyderabad, Pakistan. Int J Adv Res Technol 2014; 3:80-3.
Husain MO, Duddu V, Husain M, Drury A, Chaudhry N, Husain N. Smoking behavior among 14-17 year old students: a comparison between Pakistan and the UK. Southeast Asian J Trop Med Public Health 2012; 43:219-28.
Ganatra HA, Kalia S, Haque AS, Khan JA. Cigarette smo-king among adolescent females in Pakistan. Int J Tuberc Lung Dis 2007; 11:1366-71.
Sami N, Noorani SS, Lakhani LS, Ghouse A, Valliani S. Smoking practices and nicotine dependence among adolescents in Pakistan. J Pak Med Assoc 2013; 63:1260-5.
Zaidi SM, Bikak AL, Shaheryar A, Imam SH, Khan JA. Perceptions of anti-smoking messages amongst high school students in Pakistan. BMC Public Health 2011;11: 117. doi:10.1186/1471-2458-11-117
Khan I, Shams G, Khan SF, Ahmed SI, Khan JI. Impact of educational intervention on smoking knowledge, attit- ude and behavior of adolescents in schools of developing country, Rawalpindi Pakistan. Int J Med Biomed Stud 2019;3: 35-41. doi:10.32553/ijmbs.v3i3.142
Sajid S, Arif S, Nasir A, Bashir S, Arooj K, Amin I. Effec-tiveness of anti-smoking program among adolescence at community-based school Karachi-Pakistan. Int J Curr Res Rev 2022; 14:26-30. doi:10.31782/IJCRR.2022.142004
Rozi S, Butt ZA, Akhtar S. Correlates of cigarette smok-ing among male college students in Karachi, Pakistan. BMC Public Health 2007; 7:312. doi:10.1186/1471-2458-7-312
Ma C, Xi B, Li Z, Wu H, Zhao M, Liang Y, et al. Preval-ence and trends in tobacco use among adolescents aged13-15 years in 143 countries, 1999 To 2018: findings from the global youth tobacco surveys. Lancet Child Adolesc Health 2021; 5:245-55. doi:10.1016/S2352-4642(20)30390-4
The Toll of Tobacco in Bangladesh. Tobacco Consum-ption. Washington DC, United States of America: Campaign for Tobacco-Free Kids 2021; Updated Sept 14, 2021; cited 2023 October 28. Available from: https://www.tobaccofreekids. org/problem/toll-global/asia/bangladesh.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Fahad Ali Mangrio, Penpaktr Uthis, Suwimon Rojnawee, Alicia K Matthews
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Articles published in the Journal of Dow University of Health Sciences are distributed under the terms of the Creative Commons Attribution Non-Commercial License https://creativecommons.org/ licenses/by-nc/4.0/. This license permits use, distribution and reproduction in any medium; provided the original work is properly cited and initial publication in this journal. 
