BACKGROUND: The availability of tobacco products in schools’ close environment is a key driver of early smoking initiation alongside other psychological, financial and environmental influences. We aimed to study tobacco access and availability among middle school adolescents in Tunisia.
METHODS: The 2024- Global Youth Tobacco Survey (GYTS) is a national, cross-sectional, school-based survey. A clustered two-stage stratification approach was used for random sampling, and the survey targeted middle school adolescents aged 13–15 years. Data were anonymously collected using a standardized questionnaire containing core questions about six majors tobacco related topics, including accessibility and availability of cigarettes in the last 30 days. Percentages were presented with 95% Confidence Interval (CI).
RESULTS: A total of 2745 middle school adolescents were enrolled, with a participation rate from private schools equal to 35.9% and a sex-ratio (M/F) equal to 0.98. More than half (60.3%, 95% CI 55.3-65.0) of current cigarette smokers purchased their cigarettes from a store, shop, street vendor, or kiosk in the past 30 days. Almost third of cigarette smokers (27.7% %, 95%CI 23.4-32.3) acquired cigarettes from someone in their social environment, significantly higher in boys (30.0% Vs 19.3%, p value=0.04). Regarding the ban on selling cigarettes to minors, only (23.8%, 95%CI 19.7-28.2) of current smokers were banned from purchasing cigarettes in the past 30 days.
CONCLUSIONS: This study revealed several gaps in Tunisian legislation regarding the sale of tobacco products to minors and its availability in schools surrounding environment. The revision of the current legislation to prohibit retail sales, sales to minors, and enforce a safety distance for selling tobacco products are key elements to reduce accessibility, protect the school environment and prevent early smoking initiation.