Smoking susceptibility among school children aged 13–15 in Vietnam: a multilevel analysis of data from Global Youth Tobacco Use data (GYTS) 2014

Abstract

Background We aim to assess the prevalence of smoking susceptibility and identify factors at school and individual levels that are associated with individual susceptibility to smoking among school children aged 13–15 years in Vietnam. Methods Data came from Vietnam Global Youth Tobacco Survey (GYTS) 2014. A 2-stage sample design and proportion to population size (PPS) technique was employed to select a representative sample of study participants. Independent variables include both individual and school-level characteristics. Both descriptive and inferential statistics were performed. Logistic multilevel models were constructed to analyze the association between independent variables and smoking susceptibility status. Results The overall percentage of smoking susceptibility status was 11.2%. Boys were more susceptible to smoking than girls. The odds of smoking susceptibility were higher among students who had both of their parents smoking (adjusted odds ratio [aOR], 3.91; 95% confidence interval [CI], 2.17–7.05) and those whose best friends smoked (aOR, 4.79; 95% CI, 2.40–9.54). Knowledge on harmfulness of smoking was associated with lower odds of smoking susceptibility. Among school level factors, the schools with greater access to anti-smoking media were associated with lower susceptibility to smoking among their students (coefficient = −0.028; standard error = 0.011, P < 0.05). Conclusion This study highlights the importance of contextual exposure to anti-smoking media among the children. With the availability of multilevel modeling as an analytical tool, further refinements in the understanding of contextual effects on smoking status are needed to facilitate the development of school level policy and interventions in addition to individual level approaches.