APH 2003, 61, 151-160:

Smoking habits and cardiovascular risk factors among adolescents in Sousse, Tunisia.

H. Ghannem, I. Harrabi, A. Ben Abdelaziz, R. Gaha, L. Trabelsi

Keywords: Smoking, cardiovascular risk factors, adolescent, prevention, Tunisia

We undertook an epidemiological survey on a representative sample of 1569 pupils aged between 13 and 19 years from schools of Sousse in Tunisia to study the smoking habits of school children and their links to cardiovascular disease risk factors.

The study objectives consisted of: first, to describe Tunisian adolescent smoking behaviour and second, to assess the influence of home environment, friends and the different socio-demographic factors in acquiring and maintaining the habit. We have also examined the clustering of cardiovascular disease risk factors among smoking school children. Students were surveyed in schools using a self-administered, anonymous questionnaire. The smoking prevalence was 7.6% of our sample and boys are significantly more touched than girls: 14.7% versus 1.1%; X2 = 103.4, p = 0.00001. The smoking prevalence increased with age. For boys, it raised from 3.4% at 13 years to 32.3% at 19 years; X2 = 40.9 p = 0.0001. 60.6% of school children are exposed to passive smoking at home. The smokers had higher prevalences of hypertension and obesity but with no significant difference, however they had significantly lower High Density Lipoprotein cholesterol values (HDL) (1.35±0.27 vs 1.50±0.30 mmol/l) p<0.05. Non-smokers had higher prevalences of Low Density Lipoprotein (LDL) and triglycerides with no significant difference. Peer smoking behaviour has a clear effect on the smoking habits of boys. These findings suggest that schools and health authorities should design specific programmes to limit the extension of tabagism among youngsters.