title: Prevalence and characteristics of flavoured tobacco use among students in grades 10 through 12: a national cross-sectional study in Canada, 2012-2013.
abstract: BACKGROUND
  Tobacco use is the leading cause of preventable death in Canada and the world. Despite documented decreases in the prevalence of smoking in Canada, increases in flavoured tobacco use by its youth poses a serious public health concern. This study examined the prevalence and characteristics of flavoured tobacco use among a national sample of Canadian students in grades 10 through 12.
  
  
  METHODS
  This study used a cross-sectional design on a nationally generalizable, school-based, Youth Smoking Survey (YSS), 2012-2013. It incorporated data from a representative sample of 19,979 students in grades 10-12 from across Canada. Univariate and multivariate logistic regression models were used to examine differences in flavoured tobacco use (menthol cigarettes, flavoured little cigar or cigarillo, flavoured cigar, flavoured tobacco in water pipe [hookah]) by demographic (sex, grade and ethnicity) and social characteristics (friends, siblings, parents/guardians who are smokers and weekly personal spending money).
  
  
  RESULTS
  This study found that 14.8% of the participating students used flavoured tobacco in the past 30-days. Results of the logistic regression analysis show that flavoured tobacco use was significantly higher among male students [(OR = 1.63; 95% CI = 1.36-1.95)], who had at least one friend or sibling who smoke [(OR = 2.20; CI = 1.62 to 2.99) and (OR = 1.51; CI = 1.22 to 1.88), respectively] and who received greater than $20/week in personal spending money [(OR = 1.76; CI = 1.26 to 2.45)].
  
  
  CONCLUSIONS
  The results of our study indicate that flavoured tobacco use is a growing public health concern and has a strong appeal among youth in Canada. This is a particularly troubling finding, especially in light of the fact that there is a national ban on certain flavoured tobacco products. To be effective, strategies specifically tailored for youth using flavoured tobacco would require appropriate educational/prevention initiatives, more comprehensive legislation and better regulatory mechanisms.
authors.affiliation: School of Public Health, University of Saskatchewan, 104 Clinic Place, E-Wing Health Sciences, Room 3322, Saskatoon, SK S7N 2Z4 Canada.
authors.forename: Yelena
authors.initials: Y
authors.lastname: Bird
authors.affiliation: Health Promotion, Lung Association of Saskatchewan, Saskatoon, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: May
authors.affiliation: School of Public Health, University of Saskatchewan, 104 Clinic Place, E-Wing Health Sciences, Room 3322, Saskatoon, SK S7N 2Z4 Canada.
authors.forename: Chijioke
authors.initials: C
authors.lastname: Nwankwo
authors.affiliation: School of Public Health, University of Saskatchewan, 104 Clinic Place, E-Wing Health Sciences, Room 3322, Saskatoon, SK S7N 2Z4 Canada.
authors.forename: Razi
authors.initials: R
authors.lastname: Mahmood
authors.affiliation: School of Public Health, University of Saskatchewan, 104 Clinic Place, E-Wing Health Sciences, Room 3322, Saskatoon, SK S7N 2Z4 Canada.
authors.forename: John
authors.initials: J
authors.lastname: Moraros
keywords: Adolescents; Canada; Flavoured tobacco