title: Factors Associated with Tobacco Use among Female Adolescent Students in Dharan Municipality of Eastern Nepal.
abstract: BACKGROUND
  Rising trend of female tobacco use is a serious concern in South East Asia Region. Gender differences in tobacco use is likely to be reduced in the future with continuous modernization in low and middle income countries like Nepal.
  
  
  METHODS
  Pre tested self administered questionnaire adapted from Global Youth Tobacco Survey was used to assess tobacco use among the representative sample of 618 female adolescent students selected by stratified random sampling from different schools of Dharan Municipality from July 2011 to July 2012. Chi square test and binary logistic regression were applied. Probability of significance was set at 5%.
  
  
  RESULTS
  Prevalence of ever tobacco use was 4% (95% CI 2.4% to 5.5%).The mean age of initiation of tobacco smoking was 13.58 years (SD =1.71) and that of tobacco chewing was 13.80 years (SD = 1.47). More than a third of the tobacco users (36%) consumed tobacco at home whereas three fifth (60%) of the users purchased tobacco directly from the shops.The major reasons behind initiation of tobacco use were for recreational use (32%), pressure from friends (32%) and to relieve pain or stress in life (28%). Multivariate analysis showed that ever tobacco use was significantly associated with ever use of alcohol (AOR: 7.54, 95% CI: 2.61 to 21.78).
  
  
  CONCLUSIONS
  School and college based awareness raising campaigns are required for female adolescent students to counter the rising tobacco use (smoking and smokeless). Interventions like health education should focus on tobacco to prevent initiation during adolescence.
authors.affiliation: Department of Community Medicine and Public Health, Institute of Medicine, Tribhuvan University, Nepal.
authors.forename: P M
authors.initials: PM
authors.lastname: Singh Pradhan
authors.affiliation: MD Anderson Cancer Center, Houston, Texas, United States.
authors.forename: S
authors.initials: S
authors.lastname: Kalra
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D009390:Nepal / Q000453:epidemiology; D015995:Prevalence; D011795:Surveys and Questionnaires; D064424:Tobacco Use / Q000453:epidemiology*
keywords: Tobacco; female; adolescent; Nepal.