title: Secondhand smoke exposure and susceptibility to initiating cigarette smoking among never-smoking students in selected African countries: Findings from the Global Youth Tobacco Survey.
abstract: Exposure to secondhand smoke (SHS) causes premature death and illness in non-smokers. We examined SHS exposure at home and in public places, as well as susceptibility to initiate cigarette smoking among never cigarette smokers. We used 2006-2011 Global Youth Tobacco Survey (GYTS) data from 29 African countries (56,967 students).
  
  
  
  GYTS is a nationally representative, self-administered school-based survey, conducted among students aged 13-15years. Prevalence ratio, estimates and 95% confidence intervals were computed for SHS exposure in the homes and public places separately. The two-sample t-test was used to assess the difference in susceptibility to smoking by SHS exposure among never-smoking students (α=0.05).
  
  
  
  Among never-smoking students, exposure to SHS at home ranged from 12.7% (Cape Verde) to 44.0% (Senegal). The prevalence ratio (PR) comparing susceptibility to smoking initiation among never smokers exposed to SHS at home to those who were not exposed at home ranged from 1.2 to 2.6. Exposure to SHS in public places ranged from 23.9% (Cape Verde) to 80.4% (Mali). Of the countries being studied, 8 countries showed a significant difference in susceptibility to smoking initiation among never smokers exposed to SHS in public places compared to those not exposed in public places. (PR ranged from 0.5-3.5).
  
  
  
  In many African countries in the study, a substantial proportion of students who never smoked are exposed to SHS at home and in public places. Majority of never smokers who were exposed to SHS at home and in public places had a higher prevalence of susceptibility to initiate smoking than those that were not exposed to SHS at home and in public places. Adoption and enforcement of smoke-free policies in public places and smoke-free rules at home could substantially contribute to reducing SHS exposure in many of these countries.
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States; Northrop Grumman Information Systems, Atlanta, GA, United States.
authors.forename: Kyung A
authors.initials: KA
authors.lastname: Lee
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Krishna M
authors.initials: KM
authors.lastname: Palipudi
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Lorna M
authors.initials: LM
authors.lastname: English
authors.affiliation: World Health Organization, Regional Office for Africa, Brazzaville, Congo.
authors.forename: Nivo
authors.initials: N
authors.lastname: Ramanandraibe
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, United States.
authors.forename: Samira
authors.initials: S
authors.lastname: Asma
mesh_terms: D000293:Adolescent; D000349:Africa / Q000453:epidemiology; D005260:Female; D014943:Global Health; D006801:Humans; D008297:Male; D061845:Smoke-Free Policy; D012907:Smoking / Q000453:epidemiology*; D013334:Students / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000706:statistics & numerical data*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Africa; Global Youth Tobacco Survey; SHS exposure; Students; Susceptibility; and Youth