title: The relationship between proximity of tobacco retail outlets to schools and tobacco use among school personnel in sub-Saharan Africa.
abstract: BACKGROUND
  We investigated the impact of proximity of tobacco retail outlets to schools on tobacco-related behavior and attitudes of school personnel in sub-Saharan Africa.
  
  
  METHODS
  A pooled analysis of the 2006-2011 Global School Personnel Surveys from 19 sub-Saharan African countries was performed (n=12,201). Multivariate logistic regression analyses were applied to measure the relationship between proximity of tobacco outlets to school premises and school personnel's tobacco-related behavior and attitudes (p<0.05).
  
  
  RESULTS
  Among all school personnel, there was a significant association between the presence of tobacco outlets on school premises and current cigarette smoking (adjusted odds ratio [aOR]=3.89; 95% confidence interval [CI]: 2.17-7.20), current smokeless tobacco use (aOR=2.63; 95%CI: 1.04-6.65), and permissiveness towards tobacco industry sponsorship activities in school (aOR=2.27; 95%CI: 1.37-3.78). Complete smoke-free school policies were associated with lower odds of current cigarette smoking (aOR=0.42; 95%CI: 0.23-0.74), but were not significantly associated with current smokeless tobacco use. Among lifetime any tobacco users, there was a significant association between the presence of tobacco outlets on school premises and use of combustible (aOR=2.03; 95%CI: 1.09-3.75) and smokeless (aOR=3.85; 95%CI: 1.51-9.81) tobacco products on campus within the past year.
  
  
  CONCLUSIONS
  Policies limiting the distance of tobacco outlets from schools, coupled with complete tobacco-free school policies may reduce tobacco use among school personnel.
authors.affiliation: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, USA. Electronic address: iagaku@post.harvard.edu.
authors.forename: Israel T
authors.initials: IT
authors.lastname: Agaku
authors.affiliation: Department of Oral Pathology, University of Ibadan, Nigeria.
authors.forename: Akinyele O
authors.initials: AO
authors.lastname: Adisa
authors.affiliation: Department of Medicine, University of Ibadan, Nigeria.
authors.forename: Uyoyo T
authors.initials: UT
authors.lastname: Omaduvie
authors.affiliation: Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard School of Public Health, USA.
authors.forename: Constantine I
authors.initials: CI
authors.lastname: Vardavas
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D001294:Attitude to Health; D003132:Commerce; D005178:Faculty / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D012574:Schools; D012907:Smoking / Q000453:epidemiology*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data*
keywords: Advertisements; Cigarettes; Outlets; Point-of-sale; Proximity; Retail; Schools; Smokeless tobacco; Sponsorship; Tobacco