Interplay of family, friends and teachers’ smoking habits and their effect on smoking behaviors of in-school adolescents in Nasarawa State, Nigeria

Abstract

Adolescent smoking is strongly influenced by social networks. This cross-sectional study examined the contribution of family, friends, and teachers to the smoking habits of secondary school students aged 10-19 years in Nasarawa State, Nigeria. A total of 1,600 students were surveyed. Descriptive statistics summarized participant characteristics. Binary logistic regression assessed the independent and combined associations between smoking in the social network and students’ own smoking habits. Of the 1,600 students surveyed, nearly all of them responded. Of those who responded, just over half were boys, and the majority were aged 16–18. More than half of the respondents attended private schools, and most of them attended mixed-sex schools. The adjusted associations between smoking by a family member and students’ smoking were: ever tried smoking (OR 11.52, 95%CI 8.39-15.81), tried during the last 12 months (OR 10.98, 95%CI 7.85-15.37), and tried during the last 30 days (OR 11.28, 95%CI 7.93-16.06). These estimates were similar whether either parent, both parents, or both parents and a sibling smoked. The odds of concomitant smoking by a family member, teacher and best friend were: ever tried smoking (OR 9.61, 95%CI 6.34- 14.57), tried during last 12 months (OR 7.51, 95%CI 4.80-11.72), and tried during the last 30 days (OR 8.41, 95%CI 5.30-13.35) with the impact more on girls than on boys. When no family member smoked, the influence of a smoking teacher and/or friend was insignificant such that it could not be estimated in this study. In this Nigerian setting, family smoking behavior is the most consistent correlate of adolescent smoking. These findings highlight the potential importance of family-centered prevention programs.