Use of smokeless tobacco and cigarettes among Nigerian youths: implications for tobacco control policies in Africa

Background: Smokeless tobacco (SLT) use among youths in Africa is an emerging epidemic. This paper aimed to determine patterns of tobacco use among youths in Nigeria and the implications for tobacco control in Africa. Methods: The cross-sectional study was conducted in Benue state, Nigeria, in 2011. The study population comprised of 536 randomly selected senior high school students aged 9-19 years. Results: About 17.7% of high school youths were current SLT users, 19.4% were current smokers and an alarming 11.9% used both smokeless and cigarette tobacco. After adjustment, significant predictors of SLT use among youths included their parents' smoking status (OR 1.70, 95% C.I.: 1.01-2.87, p = 0.046) and the perception of the lack of harm from tobacco use (OR 2.06, 95% C.I.: 1.08-3.92, p = 0.027). Current cigarette smoking was again predicted by parental and peer smoking status (OR 2.58, 95% C.I.: 1.55-4.31 and OR 2.93, 95% C.I.: 1.84-4.66, respectively). Adjusted regression analysis for dual tobacco use provided similar results. Conclusion: Both SLT and cigarette use, as well as dual use remains high, particularly among rural youth. Tobacco control policies based on the Framework Convention on Tobacco Control (FCTC) that primarily focus on reducing smoking in Nigeria and other African nations where SLT is popular should be modified to address not only cigarettes but also SLT use given the high use of both products singly and concurrently.