ArticleBMC medicine2022
Prevalence and trend of smokeless tobacco use and its associated factors among adolescents aged 12-16 years in 138 countries/territories, 1999-2019.
Article in BMC medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Exploring the perceived socio-cultural factors in the initiation of smokeless tobacco among adolescents: a qualitative systematic review.BMC public health · 2026Pooled it
- The impact of tobacco cessation on buccal mucosa cancer risk: A multi-centre case-control study in India.International journal of cancer · 2026Article
- Global, regional, and national cataract burden attributable to household air pollution and smoking (1990-2021) and projection to 2050.Frontiers in public health · 2026Article
- Family Structure and Peer Influences as Correlates of Lifetime Smokeless Tobacco Use Among Undergraduate Students at The University For Development Studies, Ghana: An Analytical Cross-Sectional Study.Tobacco use insights · 2026Article
- Socioeconomic inequality in any tobacco use versus current smoking across 66 DHS countries: Indirect implications for smokeless tobacco and oral cancer prevention.Tobacco induced diseases · 2026Article
- Patterns and association between smokeless tobacco consumption and hemoglobin level among 6 to 12 years children: analytical cross-sectional study : Association between smokeless tobacco use and hemoglobin in rural Pakistani children.Journal of health, population, and nutrition · 2025Article
- Demographics and psychosocial determinants of quit intention among oral smokeless tobacco users: an analytical cross-sectional study in Saudi Arabia.BMC public health · 2025Article
- Prevalence and correlates of smoked and smokeless tobacco use in Saudi Arabia: evidence from the 2021 national health survey.Scientific reports · 2025Article
- The Impact of Maternal/In Utero Exposure of Novel Tobacco Products on the Offspring Cardiovascular Health.Cardiovascular toxicology · 2025Review
- Prevalence and determinants of tobacco use among school-going adolescents in 53 African countries: Evidence from the Global Youth Tobacco Survey.Addictive behaviors reports · 2025Article
- Nicotine dependence based on the tobacco dependence screener among heated tobacco products users in Japan, 2022-2023: The JASTIS study.Neuropsychopharmacology reports · 2025Article
- The impact of oral health disparities on smoking prevalence.Frontiers in public health · 2025Review
- Sociodemographic inequalities in cigarette, smokeless tobacco, waterpipe tobacco, and electronic cigarette use among adolescents aged 12-16 years in 114 countries: A cross-sectional analysis.Tobacco induced diseases · 2024Article
- Article
- Non-pharmacological interventions for smoking cessation: analysis of systematic reviews and meta-analyses.BMC medicine · 2023Review
- Effectiveness of health promotion intervention on the knowledge and selected practices related with oral cancer among a group of vulnerable youth in Sri Lanka.BMC public health · 2023Article
- Article
- Prevalence of Tobacco Products' Use and Associated Factors Among Adolescents in Morocco: A Systematic Review.Substance use : research and treatmentReview
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Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundSmokeless tobacco use is popular in some regions worldwide, but it receives less attention compared to cigarette smoking. We aimed to estimate the recent prevalence of, and trends in, smokeless tobacco use and to examine its associated factors among adolescents aged 12-16 years in 138 countries/territories (hereafter "countries") from 1999 to 2019.
methodsData from the Global Youth Tobacco Survey conducted in 138 countries in 2010-2019 and the National Youth Tobacco Survey conducted in the United States in 2019 were used to calculate the prevalence of current smokeless tobacco use and investigate its associated factors among adolescents aged 12-16 years. We also assessed the trend in the prevalence of smokeless tobacco use in 100 countries that had conducted more than one survey from 1999 to 2019.
resultsThe overall prevalence of current smokeless tobacco use was 4.4% (95% confidence interval [CI] 4.0-4.9), with 5.7% (5.1-6.3) for boys, 3.1% (2.6-3.5) for girls, 3.9% (3.5-4.4) for adolescents aged 12-14 years and 5.4% (4.8-5.9) for those aged 15-16 years. The prevalence was highest in the South-East Asian region (6.1%, 4.4-7.7) and lowest in the Western Pacific region (2.0%, 1.7-2.4). The prevalence of smokeless tobacco use decreased in 57 of 100 countries, increased in 32 countries, and remained unchanged in 11 countries. Current cigarette smoking (odds ratio [OR]=2.00, 95% CI=1.68-2.39), other tobacco product use (OR=6.03, 95% CI=4.92-7.40), tobacco advertisement exposure (OR=1.44, 95% CI=1.19-1.74), being offered free tobacco products (OR=2.01, 95% CI=1.66-2.42), and not being taught about dangers of smoking (OR=1.28, 95% CI=1.09-1.50) were all positively associated with current smokeless tobacco use.
conclusionsSmokeless tobacco use among adolescents remains a public health concern worldwide. Although the prevalence among adolescents decreased in most countries, it remains high especially in the South-East Asian region. More strict and effective strategies and measures are needed to further curb the smokeless tobacco use among adolescents.
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