Chi-rectangular research was utilized to evaluate to have variations in new incidence ranging from sexes, age range, and other subgroups

Chi-rectangular research was utilized to evaluate to have variations in new incidence ranging from sexes, age range, and other subgroups
S.: n=thirteen,689) divided because of the attempt sized per nation increased by the unique loads

According to the complex sampling design of the GYTS, the weighted prevalence estimates and their 95% confidence intervals (CI) of smokeless tobacco use in each country were calculated using original sampling weights, strata, and pripling units provided in the datasets using the SAS PROC SURVEYFREQ procedure. The original weights were calculated by the following formula: W=W1*W2*f1*f2*f3*fcuatro, where W1 is the inverse of the selection probability of each school; W2 is the inverse of selection probability of each class; f1 is the school-level non-response adjustment factor calculated by school enrolment size; f2 is the class-level non-response adjustment factor for each school; f3 is the student-level non-response adjustment factor for each class; f4 is the post-adjustment stratification factor calculated by grade and sex. We rescaled the original weights to calculate the overall and subgroups’ prevalence of smokeless tobacco use based on each country’s sample size. The rescaled weights were calculated as the maximum country sample size (i.e., U. Chi-square trend test was used to examine the secular trend in the prevalence with consideration of data from all surveys in each country between 1999 and 2019. The prevalence estimates of secular trends were calculated per 5 calendar years. Multivariable logistic regression models were used to assess the association of potential associated factors (sex, age, cigarette smoking, other tobacco product use, parental smoking, smoking status of closest friends, tobacco advertisement exposure, being offered free tobacco products, being taught about dangers of smoking, and World Bank income level) with current smokeless tobacco use, and the code for each variable is shown in Additional file 1: Table S1. In order to correct the overall probability of type I error in multiple statistical tests (?=0.05), the Bonferroni’s correction was used to adjust the critical significance level of each statistical test. The corrected critical significance level was equal to the original critical significance level (0.05) divided by the number of tests performed. A two-sided P-value less than the Bonferroni’s corrected critical significance level was regarded as statistical significance and SAS 9.4 (SAS Institute, Cary, NC, US) was used for all analyses.


All in all, 450,691 teens (boys: 51.4%) aged several–sixteen age off 138 nations surveyed anywhere between 2010 and you can 2019 was in fact integrated to help you guess the newest incidence of latest smokeless tobacco use and their associated circumstances. Certainly one of 138 integrated nations interviewed this current year–2019, 23 (sixteen.7%) had been from the African part, 29 (21.7%) throughout the American part, 23 (sixteen.7%) from the Eastern Mediterranean region, 31 (twenty two.5%) about Western european region, nine (6.5%) in the Southern-East Far-eastern part, and you may twenty two (fifteen.9%) on West Pacific part (Even more document 1: Desk S2).

Based on the latest studies from 138 countries this current year-2019, the general incidence from latest smokeless using tobacco try cuatro.4% (95% CI cuatro.0–4.9), with 5.7% (5.1–6.3) for men, 3.1% (dos.6–step three.5) for girls, 3.9% (3.5–cuatro.4) for teens aged a dozen–fourteen many years, and you may 5.cuatro% (4.8–5.9) for those aged 15–16 decades (Desk step one). The newest frequency ranged somewhat all over the 138 nations (regarding 0.0% during the Tokelau to help you 51.6% in Kiribati), and by sex and generation contained in this every one of really places (Fig. step one, and extra file step one: Fig. S2 and Dining table S3). Brand new prevalence was nearly 5 times highest among latest cigarette smokers compared with low-cigarette smokers (fourteen.3% versus. 3.0%), and you can nearly 7 minutes large among most other cigarette product users compared that have low-profiles (twenty two.5% versus. 3.2%). The newest frequency certainly teenagers whose both dad and mom (9.8%), and you may mom only (5.6%) smoked are greater than those whose dad only (cuatro.4%) and you can neither mother (cuatro.7%) smoked. The prevalence is large on the Southern area-Eastern Far-eastern area (6.1%), followed closely by the fresh African part (5.4%), and you will lowest throughout the Western Pacific region (dos.0%). The latest frequency are higher in down-middle-earnings regions (5.5%), followed by reduced-money places (cuatro.7%), and reasonable within the high-income regions (dos.8%) (Dining table step 1).

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