Predictors of smoking initiation among Thai adolescents from low-income backgrounds: A case study of Nakhon Pathom low-cost housing estates.

INTRODUCTION: Globally, an estimated 1.3 billion people in the world smoke tobacco products, of which more than 8 million die annually. A disproportionate number of these deaths occur in low- and middle-income countries like Thailand. Over 19% (10.7 million) of the Thai population aged ≥15 years were estimated to be smokers; of these, 7.8% were aged 15-18 years. Nearly 1 in 10 Thai students is a current tobacco user; about 20% of these smokers had initiated smoking before their 10th birthday. This shows that early smoking initiation among Thai youths is indeed a public health problem. This study was conducted to examine the factors associated with smoking initiation among adolescents from low-income backgrounds. METHODS: A cross-sectional study was conducted among youth aged 15-18 years living in low-cost housing estates in Nakhon Pathom province between 1 December 2019 and 30 July 2020. A total of 290 participants were recruited by stratified random sampling. A proprietary questionnaire was used to collect the data, which were analyzed by binary logistic regression. RESULTS: Risk factors for smoking initiation were having one or both parents deceased (OR=2.28; 95% CI: 1.218-3.471, p=0.001), having divorced parents (OR=1.67; 95% CI: 1.158-2.509, p=0.013), and poor academic performance (OR=2.50; 95% CI: 0.133-3.551, p=0.032). Protective factors were having knowledge of cigarettes (OR=0.65; 95% CI: 0.179-0.895, p=0.004) and correct perception of legal public smoking places (OR=0.45; 95% CI: 0.140-0.850, p=0.025). CONCLUSIONS: To curb the risks of early smoking initiation among youths of low-income backgrounds, both education and health authorities need to collaboratively design interventions tailored to raise awareness of the negative health impacts of tobacco, improve the performance of underperforming students, and meet the social needs of students whose parents are either deceased or separated to improve their social ties.

Prevalence and Correlates of Alcohol Consumption among Hill-Tribe Adolescents below the Legal Drinking Age-A Community-based Cross-Sectional Study in Northern Thailand.

Alcohol drinking has been prevalent among various hill tribes of northern Thailand due to their distinctively different lifestyles, traditions, cultures and beliefs than the general Thai population; the majority of these traditions involve annual rounds of customary rituals that make alcohol abundantly accessible to all age groups. To study the prevalence and predictors of alcohol use, a community-based analytical cross-sectional study was conducted between October 2017-September 2018 among 480 sampled adolescents aged 12 through 18 years drawn by stratified random sampling. A proprietary questionnaire developed by the researchers was used to collect the data which were analyzed using binary logistic regression. The prevalence of alcohol use in the previous 30 days was 46.7%. Drinking predictors were: having at least a drinking parent, drinking peers, ever been sent to buy alcohol, smoking, cordial relationship with peers, gambling, family violence experience, stress and leisure time company. Therefore, our results suggest that prevention interventions should be designed with a focus on discouraging parents from sending children to buy alcohol and drinking or smoking in their presence; to reduce both social and commercial access to alcohol, age limits should be imposed on alcohol intake at all ceremonious events, while strictly reinforcing the law that prohibits selling alcohol to minors.

Knowledge, Attitude and Perception of Risk and Preventive Behaviors toward Premarital Sexual Practice among In-School Adolescents.

Premarital Sexual Practice (PSP) among adolescents usually involves sexually risky behaviors, such as multiple sexual partners and inconsistent or non-condom use. These behaviors, in combination with other underlining factors, undermine the overall outcomes of Adolescent Sexual and Reproductive Health (ASRH). To assess the adolescents' knowledge, attitudes and perception of risk and preventive behaviors towards PSP, a school-based analytical cross-sectional study was conducted among a sample of 423 students aged 15 through 19 years. A well-validated anonymous self-administered questionnaire was used for collecting the data, which were analyzed using mean (SD), frequency (%), t-test, ANOVA and multiple regression methods. Participants' knowledge of risk and preventive behaviors was average, as only 53% of knowledge items were correctly answered. Being a female, of high-income status, in the second study year, perceived susceptibility and perceived severity were significant determinants of knowledge. All measures of perception except perceived self-efficacy were positive determinants of attitude. Being female, in the third study year and of high-income status were determinants of perception as measured by perceived self-efficacy. Therefore, our results suggest that tailored educational programs, with special emphasis on financially disadvantaged male adolescents, are needed to effectively increase adolescents' knowledge, attitude and perception of risk and protective behaviors towards PSP.