Country and gender differences in the association between violence and cigarette smoking among youth
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RESEARCH
Open Access
Country and gender differences in the association between violence and cigarette smoking among youth Niveen M. E. Abu-Rmeileh1, Ethel Alderete2, Abdullatif Husseini1, Jennifer Livaudais-Toman3 and Eliseo J. Pérez-Stable4*
Abstract Background: Exposure to violence in youth may be associated with substance use and other adverse health effects. This study examined cigarette smoking in two middle-income areas with different levels and types of exposure to violence. Methods: Association of exposure to verbal and physical violence with cigarette smoking in the West Bank oPt (2008) and in Jujuy Argentina (2006) was examined using cross-sectional surveys of 14 to 17-year old youth in 7th to 10th grade using probabilistic sampling. Results: Violence exposure rates were more than double for Palestinian girls (99.6% vs. 41.2%) and boys (98.7% vs. 41.1%) compared with Argentinians. The rate of current cigarette smoking was significantly higher among Argentinian girls compared with Palestinian girls (33.1% vs. 7.1%, p < 0.001). Exposure to verbal violence from family and to physical violence increased the odds of current cigarette smoking, respectively, among Argentinian girls (aOR = 1.3, 95% CI = 1.0–1.7; aOR = 2.5, 95%CI = 1.7–3.8), Palestinian girls (aOR 2.2, 95%CI = 1.1–2.4; aOR = 2.0, 95%CI = 1.1–3.6) and Argentinian boys (aOR = 1.5, 95%CI = 1.1–2.0; aOR = 2.2, 95%CI = 1.6–3.0), but not among Palestinian boys. Conclusion: Findings highlight the importance of producing context and gender specific evidence from exposure to violence, to inform and increase the impact of targeted smoking prevention strategies. Keywords: VIOLENCE, SMOKING, YOUTH, GENDER, CROSS-COUNTRY
Introduction Expert reports express concern over increasing or persistently high smoking prevalence in low- to middle Human Development Index (HDI) countries. Another major concern is an increase in smoking prevalence among youth, particularly among girls [1, 2]. Although the lack of full implementation of tobacco control policies in many countries undermines global tobacco * Correspondence: [email protected] 4 Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, USA Full list of author information is available at the end of the article
control efforts [1], the complex interplay of bio-socialenvironmental factors that promote smoking in subgroups of youth with different socioeconomic, cultural and contextual characteristics are not sufficiently understood. This gap in knowledge sets limits to the development of prevention tools with effectiveness in addressing diversity within and across countries. Risk factors associated with youth smoking like peer and media influences, have been consistently identified across countries from varied HDI levels [3–9]. Evidence supports the role of social norms that may influence substance use behavior, including smoking, with
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 Internat
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