Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Research article

Cigarette and waterpipe smoking among adolescents in Estonia: HBSC survey results, 1994–2006

Kersti Pärna12*, Janika Usin1 and Inge Ringmets12

Author Affiliations

1 Department of Public Health, University of Tartu, Estonia

2 Estonian Centre of Excellence in Behavioural and Health Sciences, Tallinn, Tartu, Estonia

For all author emails, please log on.

BMC Public Health 2008, 8:392  doi:10.1186/1471-2458-8-392

Published: 25 November 2008

Abstract

Background

Smoking is a major single cause of preventable morbidity and premature mortality. Tobacco use among adolescents is a significant public health problem as smoking behaviour is undeniably established in adolescence. While cigarette smoking among adolescents has been a significant public health problem for years, waterpipe smoking is considered to be a new global public health threat. The objectives of this study were to describe trends of cigarette smoking and the prevalence of waterpipe smoking and to study the association between cigarette and waterpipe smoking among adolescents in Estonia.

Methods

This study was based on a four-yearly HBSC survey of health behaviour among school-aged children conducted in 1994–2006 in Estonia. It was a school-based survey of a nationally representative sample using standardized methodology. The target group of the survey were 11-, 13-, and 15-year-old schoolchildren (N = 13826), 6656 boys and 7170 girls. Cigarette and waterpipe smoking was determined on a 4-stage scale: every day, at least once a week, less than once a week, not smoking. Logistic regression analysis was applied to examine gender- and age-specific smoking trends and to study the association between cigarette and waterpipe smoking.

Results

Prevalence of smoking was higher among boys than girls in all age groups during the whole study period. The prevalence of cigarette smoking increased in 1994–2002 and then slightly decreased in both genders. The increase in smoking was larger among girls. Among girls, daily smoking increased during the whole study period. Among 15-year-old schoolchildren one-third of the boys and one quarter of the girls were cigarette smokers, 21% of the boys and 12% of the girls were daily smokers in 2006. One fourth of the boys and one sixth of the girls were waterpipe smokers. A logistic regression analysis revealed a strong association between cigarette and waterpipe smoking among schoolchildren.

Conclusion

The results of this study can significantly enhance the capacity to develop and implement tobacco prevention and control programmes among the youth in Estonia.