Tobacco-promotional activities in rural Sri Lanka: a cross-sectional study of knowledge, exposure and responses among adolescent schoolchildren
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World Health Organization. Regional Office for South-East Asia
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Background: Tobacco promotions are linked to tobacco consumption inadolescents. The aim of this study was to determine knowledge of and exposureand responses to tobacco-promotional activities and factors associated withknowledge among adolescents in a rural setting in Sri Lanka.Methods: Seven schools in Polonnaruwa district were randomly selected for thiscross-sectional study. Adolescents (n = 500) aged 14–15 years in grade 10 wereselected using convenience sampling and studied by using a self-administeredquestionnaire during June–October 2014. The questions on exposure to tobaccopromotional activities were based on the validated questionnaire of the GlobalYouth Tobacco Survey. Adolescents were categorized into two levels of knowledge,exposure and responses to tobacco promotions, based on the scores obtained.Selected factors associated with knowledge of tobacco promotions were assessedusing univarate and multivariate analyses.Results: The response rate was 99.6% (498/500). The mean age of theadolescents was 14.9 years (standard deviation ±0.37) and the proportion offemales was slightly higher (n = 280, 56.2%) than for males. The prevalence ofcurrent smoking was 3.2% (n = 16). Half (48.6%, n = 242) of the adolescents hada good level of knowledge of tobacco-promotional activities. Most (64.9%, n = 323)had experienced a low level of exposure to tobacco-promotional activities, while85.7% (n = 427) indicated that they had responded/would respond assertively toexposure to tobacco promotion. In the univariate analysis, having a mother witha high level of education (odds ratio [OR] 1.742), having a father with a high levelof education (OR 1.997) and the student attending a type 1AB school (OR 1.310)were significant factors associated with a good level of knowledge of tobaccopromotional activities. A father with a high level of education (adjusted OR 1.772)and the student attending a type 1AB school (adjusted OR 1.455) were the factorsassociated with a good level of knowledge for tobacco-promotional activities, whenconfounding effects of the variables were taken into consideration.Conclusion: Knowledge of tobacco-promotional activities was poor among theadolescents in the rural setting in Sri Lanka. Nevertheless, most of the adolescentsin the study population indicated that their responses to such exposures were/would be assertive
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