Smoking practices and nicotine dependence among adolescents in Pakistan.

Objective: To find out the smoking prevalence and associated factors among in-school and out-of-school adolescents and their nicotine dependence. Method: The cross-sectional study was conducted from April to June 2008 comprising 1014 adolescents aged 1218 years residing in two rural. districts of Sindh and Punjab. Trained interviewers collected information from the adolescents regarding age, ethnicity, religion, occupation and education of parents, smoking behaviour, smoking history of family/friend, type of family system, number of siblings and place of residence. Statistical package Epi-Info version 6 was used to enter the data and analysis was performed by using SPSS version 12. Results: Overall smoking prevalence among the 1014 adolescents was 15.2%, with significant gender stratification (7.9% among girls versus 20.2% among boys). Of these, 50% were moderately nicotine dependent. However, the prevalence among in-school adolescents (14.6%) was not significantly different from out-of-school adolescents (16.1%). The factors associated with adolescents' smoking were father's illiteracy (adjusted odds ratio [OR]= 8.2), friend's smoking (adjusted OR=6.8), father's smoking (adjusted OR=5.4) and nuclear family setup (adjusted OR=3.6). When explored for the first place of smoking, friends' home was mentioned by majority of adolescents boys and girls. Conclusion: Although there was a significant difference found between the prevalence of smoking among adolescent males and females, but any difference among in-school and out-of-school adolescents smoking prevalence could not be established.