Factors associated with intention to smoke cigarette in never-smoking South African school learners

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BACKGROUND: Tobacco smoking represents a significant risk behaviour that often begins in adolescence; thus, identifying predictors of smoking initiation is crucial for the development of effective and culturally sensitive prevention interventions. Yet, only limited information is available on risk for smoking initiation among South African adolescents using large nationally representative sample. This study seeks to identify factors associated with the intention to smoke among never-smoking adolescents aged 13-15 years in South Africa. METHODS: Data from the Global Youth Tobacco Survey (2011), a nationally representative, school-based survey, were used. Participants comprised 2573 never-smoking adolescents aged 13-15 years. Chi-Square tests and multiple logistic regression analyses were conducted to identify factors associated with adolescents' intention to smoke. RESULTS: Overall, 17.6% of never-smoking South African adolescents aged 13-15 years had intention to smoke in the future. Adolescents with an intention to smoke were more likely to report knowledge of the harms associated with smoking (AOR = 2.14; 95% CI: 1.44-3.18; p = 0.001), having friends who smoke (AOR = 2.44; 95% CI: 1.74-3.42; p < 0.001), being male, and exposure to second-hand smoke in other places other than at home. CONCLUSION: These findings suggest that peer influence, second-hand smoke exposure, and gender are important factors associated with smoking intention among adolescents. While the study is based on 2011 data, it provides useful insights for informing prevention strategies. Interventions may benefit from focusing on reducing peer influence, limiting exposure to second-hand smoke, and strengthening school-based tobacco education. However, findings should be interpreted in light of the study's limitations.

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