Chi-rectangular analysis was applied to check on getting differences in the newest incidence between sexes, a long time, and other subgroups

Chi-rectangular analysis was applied to check on getting differences in the newest incidence between sexes, a long time, and other subgroups
S.: n=13,689) split up because of the attempt sized for every nation multiplied by modern loads

According to the complex sampling design of the GYTS, the weighted prevalence estimates and their 95% confidence intervals (CI) of smokeless tobacco use in each country were calculated using original sampling weights, strata, and pripling units provided in the datasets using the SAS PROC SURVEYFREQ procedure. The original weights were calculated by the following formula: W=W1*W2*f1*f2*f3*f4, where W1 is the inverse of the selection probability of each school; W2 is the inverse of selection probability of each class; f1 is the school-level non-response adjustment factor calculated by school enrolment size; f2 is the class-level non-response adjustment factor for each school; f3 is the student-level non-response adjustment factor for each class; f4 is the post-adjustment stratification factor calculated by grade and sex. We rescaled the original weights to calculate the overall and subgroups’ prevalence of smokeless tobacco use based on each country’s sample size. The rescaled weights were calculated as the maximum country sample size (i.e., U. Chi-square trend test was used to examine the secular trend in the prevalence with consideration of data from all surveys in each country between 1999 and 2019. The prevalence estimates of secular trends were calculated per 5 calendar years. Multivariable logistic regression models were used to assess the association of potential associated factors (sex, age, cigarette smoking, other tobacco product use, parental smoking, smoking status of closest friends, tobacco advertisement exposure, being offered free tobacco products, being taught about dangers of smoking, and World Bank income level) with current smokeless tobacco use, and the code for each variable is shown in Additional file 1: Table S1. In order to correct the overall probability of type I error in multiple statistical tests (?=0.05), the Bonferroni’s correction was used to adjust the critical significance level of each statistical test. The corrected critical significance level was equal to the original critical significance level (0.05) divided by the number of tests performed. A two-sided P-value less than the Bonferroni’s corrected critical significance level was regarded as statistical significance and SAS 9.4 (SAS Institute, Cary, NC, US) was used for all analyses.


All in all, 450,691 teenagers (boys: 51.4%) aged several–sixteen ages from 138 countries surveyed between 2010 and you may 2019 have been integrated to help you estimate the fresh frequency out-of latest smokeless tobacco use and you will its related things. Certainly one of 138 integrated places interviewed this current year–2019, 23 (sixteen.7%) had been throughout the African area, 30 (21.7%) from the Western region, 23 (sixteen.7%) from the East Mediterranean region, 31 (twenty two.5%) in the Eu area, nine (six.5%) in the South-East Far-eastern part, and you will twenty-two (fifteen.9%) regarding the West Pacific part (Extra document step 1: Desk S2).

In line with the most recent data of 138 places this season-2019, the entire prevalence regarding newest smokeless using tobacco try cuatro.4% (95% CI cuatro.0–4.9), which have 5.7% (5.1–six.3) to possess boys, 3.1% (2.6–3.5) for girls, step three.9% (step three.5–4.4) having kids aged a dozen–fourteen years, and 5.cuatro% (4.8–5.9) for those old 15–sixteen decades (Dining table 1). The fresh new frequency ranged significantly across the the 138 countries (regarding 0.0% from inside the Tokelau so you can 51.6% in the Kiribati), by intercourse and you may age group within each of very places (Fig. step one, and extra document 1: Fig. S2 and Desk S3). The new frequency is nearly five times large certainly one of latest cigarette smokers in contrast to low-smokers (fourteen.3% compared to. step 3.0%), and you will nearly seven times high among other tobacco cigarette equipment users opposed having non-profiles (twenty two.5% against. step three.2%). The fresh new prevalence one of kids whose both parents (nine.8%), and you may mommy merely (5.6%) smoked is actually higher than those individuals whose father merely (cuatro.4%) and you will neither mother or father (4.7%) used. The fresh new frequency was highest about Southern area-East Far-eastern part (six.1%), followed by this new African part (5.4%), and you can lower about West Pacific area (2.0%). The fresh prevalence try large in down-middle-earnings nations (5.5%), with low-money countries (cuatro.7%), and you may lower from inside the higher-earnings countries (2.8%) (Dining table step one).

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