Epidemiology and Health

Original Article

Smokeless tobacco consumption and its association with tobacco control factors in the Western Pacific Region: results from the Global Youth Tobacco Survey 2015-2019: Chandrashekhar T. Sreeramareddy, Anusha Manoharan; Epidemiol Health. 2022;44:e2022103. Published online November 8, 2022; DOI: https://doi.org/10.4178/epih.e2022103

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Abstract

OBJECTIVES
We estimated the prevalence of smokeless tobacco (ST) consumption and its associations with tobacco control factors among school-going youth in 18 Western Pacific Region (WPR) countries.

METHODS

We analyzed school-based Global Youth Tobacco Survey (2014-2019) microdata from 18 WPR countries and estimated weighted prevalence rates of ST consumption, cigarette smoking, and dual use. We used multilevel binary logistic regression to examine the associations of ST consumption and dual use with demographic variables, exposure to pro-tobacco and anti-tobacco factors, national income, and MPOWER indicators.

RESULTS

Data from 58,263 school-going youth were analyzed. The prevalence of past 30-day ST consumption was highest in Kiribati (42.1%), the Marshall Islands (26.1%), Micronesia (21.3%), Palau (16.0%), and Papua New Guinea (15.2%). In adjusted multilevel models, ST consumption and dual use were significantly associated with sex, age, parental smoking, pro-tobacco factors, national income, and MPOWER score. For each unit increase in score for cessation programs, we observed approximately 1.4-fold increases in the odds of youth ST consumption (adjusted odds ratio [aOR], 1.38; 95% confidence interval [CI], 1.15 to 1.66) and dual use (aOR, 1.47; 95% CI, 1.16 to 1.86). Similarly, for each unit increase in score for health-related warnings, the odds of both ST consumption (aOR, 0.47; 95% CI, 0.42 to 0.53) and dual use (aOR, 0.35; 95% CI, 0.30 to 0.42) decreased by approximately 60%.

CONCLUSIONS

The prevalence of youth ST consumption was substantial in the Pacific Islands, exceeding that of cigarette smoking in some countries. Implementing MPOWER measures for ST products could help reduce ST consumption.

Summary

Key Message
The prevalence of smokeless tobacco consumption, and cigarette smoking is considerably high among the school going youth in five pacific island nations of Western Pacific Region. Exposure to pro-tobacco factors and parental smoking were positively associated with youth smokeless tobacco consumption as well as dual use (both smokeless tobacco and cigarettes smoking) Closer monitoring and strict tobacco control policies are needed to prevent further escalation of smokeless tobacco consumption.

Citations

Citations to this article as recorded by

Impact of Smokeless Oral Nicotine Products on Cardiovascular Disease: Implications for Policy, Prevention, and Treatment: A Policy Statement From the American Heart Association
Cheryl R. Dennison Himmelfarb, Neal L. Benowitz, Melissa D. Blank, Aruni Bhatnagar, Paul J. Chase, Esa M. Davis, Jessica L. Fetterman, Brittney Keller-Hamilton, Oluwabunmi Ogungbe, Robert L. Page, Mary Rezk-Hanna, Rose Marie Robertson, Laurie P. Whitsel
Circulation.2025;[Epub] CrossRef
Regional Variations in the Prevalence of Risk Factors and Non-Communicable Diseases in Papua New Guinea: A Scoping Review
Bobby Porykali, Ryley Gronau, Phyllis Tran, Juliana Chen, Margaret Allman-Farinelli, Anna Rangan, Shelina Porykali, Robin Oge, Hans Nogua, Alyse Davies
International Journal of Environmental Research and Public Health.2025; 22(1): 102. CrossRef
Single, Dual, and Poly Use of Tobacco Products, and Associated Factors Among Adults in 18 Global Adult Tobacco Survey Countries During 2015–2021
Chandrashekhar T. Sreeramareddy, Kiran Acharya, N. RamakrishnaReddy
International Journal of Mental Health and Addiction.2024;[Epub] CrossRef

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