RESEARCH PAPER
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The aim of this study was to evaluate the potential impact of the changes in the national legislation on tobacco consumption and the impact of the implementation of the National Tobacco Control Program on ninth-grade students in Chisinau, Moldova, during 2015 and 2018, as well as tobacco consumption behavior and exposure to pro- and anti-tobacco messages.

Methods:
The study sample consisted of the ninth-grade students from 132 schools in Chisinau, Moldova. It included 20 randomly selected schools (3 gymnasiums and 17 high schools). Data were collected using a validated self-completed questionnaire, once in October–December 2015 (n=368) and repeated in February–April 2018 (n=819). The chi-squared test was applied to compare categorical variables between the 2015 and 2018 groups.

Results:
The student participants had mean age of 14.8 ± 0.49 years (2015) and 14.9 ± 0.53 years (2018), and, by coincidence, both groups had 51.9% boys and 48.1% girls. However, despite the rather strict regulations on tobacco in Moldova, adolescents still report a significant increase in the prevalence of cigarette consumption in the last 30 days in the period from 2015 to 2018. In this period, anti-smoking messages increased significantly and were seen by students in shopping malls, supermarkets (35.1% in 2015 and 60.0% in 2018), cinemas (11.7% in 2015 and 36.5% in 2018), magazines and newspapers (19.3% in 2015 and 37.6% in 2018) (p<0.001).

Conclusions:
Tobacco consumption among ninth-grade pupils had increased between 2015 and 2018 in Chisinau, Moldova. Adolescents represent a critical subpopulation of smokers and tobacco control experts must concentrate their efforts to reduce their exposure to pro-smoking messages and increase their exposure to anti-smoking messages (via internet, sport events, etc.).

CONFLICTS OF INTEREST
The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.
FUNDING
There was no source of funding for this research.
ETHICAL APPROVAL AND INFORMED CONSENT
The study obtained the approval of the Ethics Commission of Scientific Research of the University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, Romania, where the ASPIRA program was implemented (Decision No. 19/20.05.2013 and 42/23.02.2018). Parents were informed of the purpose, benefits and risks of the research and gave their written consent before conducting the questionnaire.
DATA AVAILABILITY
The data supporting this research are available from the authors on reasonable request.
AUTHORS' CONTRIBUTIONS
ZÁ coordinated and planned the study. VN designed, carried out the statistical analysis and data interpretation. MT was in charge of the English translation and references citations. AT performed the implementation of the study, drafted and wrote the final version of the manuscript. All authors were involved in the critical review of the manuscript and have approved the final version for publication.
PROVENANCE AND PEER REVIEW
Not commissioned; externally peer reviewed.
 
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