BACKGROUND: Smokeless tobacco (SLT) use has been associated with ill health such as oral diseases, various cancers, cardiovascular diseases, mental illnesses and addiction. Whilst some information is available at regional level, there is no information on prevalence and correlates for smokeless tobacco at national level in Zambia, hence, this study.
METHODS: This was a stratified cross-sectional school based survey. The sample size was estimated under the technical advice of WHO and CDC. The required sample sizes were 25 schools and 1875 students for each region. Overall, the sample sizes were 81 schools and 8336 students. PC Sample software for the GYTS was used to select students. Data analysis was conducted using IBM SPSS Statistics Version 20, Release 20.0.0. The data was weighted considering different nonresponse rates. Adjusted odds ratios and 95% Confidence intervals were used to adjust for confounding factors.
RESULTS: The current smokeless tobacco user rate among students in Zambia was 7.5% (7.5% among males and 7.4% among females). Age was inconsistently associated with current smokeless tobacco use with students age <13, 14 and 15 (AOR=1.23; 95% CI: 1.19, 1.27) years being more likely to currently use smokeless tobacco, and students aged 13 (AOR=0.68; 95% CI: 0.65, 0.70) and 16 years being less likely to currently use smokeless tobacco compared with students aged 17 years or older. Students who currently smoked cigarettes were 2.88 (95% CI: 2.83, 2.94) times more likely to be current smokeless tobacco users compared to students who were non-cigarette smokers.
CONCLUSIONS: Cigarette smoking is a significant risk factor for SLT use among school going adolescents in Zambia. Although the prevalence of SLT is relatively low, interventions are needed to further curb the smokeless tobacco use by targeting adolescents who smoke.