Tobacco and young people: the alarming situation in Tunisia

Tunisia is lagging far behind in its fight against smoking. A study published in January in the journal Tobacco Induced Disease highlights the "alarming" prevalence of smoking, the ease of access to tobacco products by younger generations, and the non-compliance with current public health regulations.

The study is based on figures from the 2017 Global Youth Tobacco Survey, a global survey on youth smoking. In total, it was conducted in 67 schools and involved 2,448 adolescents, of whom 1,863 were aged 13 to 15.[1].

Smoking is widespread among adolescents in Tunisia

Tobacco initiation is already well underway in this age group: more than a third of boys have already tried smoking, compared to 10% of girls. Furthermore, 12.7% of Tunisian adolescents have already tried hookah, including more than one in five boys. During the month preceding the survey, 13% of young men reported having used it. At the time of the survey, 11.9% of the adolescents surveyed reported having used tobacco in the last thirty days, whether it was a combustible or smokeless product. These results differ according to the sex of the respondents: 4.8% of the young girls surveyed reported having smoked in the month, compared to 19.4% of the boys. Finally, regular smoking concerns a smaller proportion of adolescents: 2.2% of them had used tobacco for at least 20 days in the last month. Here again, we observe a clear difference, since this smoking only concerns 0.1% of girls, but 4.2% of boys.

The prohibitions protecting young people are very poorly respected

The study shows that young Tunisian adolescents have easy access to tobacco products. In particular, while half of the respondents said they obtain tobacco by buying packs, nearly 40% of them said they obtain all or part of their tobacco by buying single cigarettes, while this practice is currently prohibited in Tunisia. Regarding the origin of cigarettes and shisha tobacco, 56% of respondents said they obtain their supplies from retailers or gas stations. Nearly three out of ten respondents said they obtain these products from a third party, while the illicit origin of tobacco seems to be very much in the minority (6.9% of respondents). Since the ban on the sale of tobacco to minors is not in force in Tunisia, 23.2% of adolescents said they were prevented from buying cigarettes because of their age, compared to 41.6% for hookah.

A high proportion of young smokers want to quit smoking

The authors of the study emphasize that the majority of smokers want to quit smoking, and this from adolescence. Thus, among the young people surveyed who said they had smoked cigarettes in the month preceding the survey, 60% said they wanted to stop smoking, and 56.6% of them mentioned having already tried. Similarly, among cigarette and hookah smokers, more than seven out of ten said they had asked for help to quit (76% of boys and 53.8% of girls). These figures demonstrate the very rapid onset of tobacco addiction. They also show the degree of tobacco addiction among young consumers: the earlier initiation begins, the stronger the tobacco addiction.

Passive smoking among adolescents, an endemic problem in Tunisia

The survey results also demonstrate the weakness of protection of Tunisian youth against passive smoking. More than three-quarters of respondents say they are exposed to smoke inside schools. In both indoor and outdoor public places, this proportion is around 60%. Finally, almost half of adolescents mention exposure to passive smoking within the family home.

The need for public authorities to address the tobacco issue

In terms of tobacco, Tunisia reports the worst health situation in the Maghreb, and remains by far one of the countries in Africa where smoking is the most prevalent. According to a recent study, the smoking prevalence of men over the age of fifteen is estimated at 49.3%, suggesting a major human, financial and environmental cost for the country in the years to come. The authors of the study therefore recommend that the public authorities ban the sale of tobacco products to minors, ensure the effectiveness of smoking bans in public places, and ban tobacco advertising in points of sale. Finally, the researchers stress the need for Tunisia to implement a tax policy to reduce tobacco consumption, in accordance with Article 6 of the World Health Organization Framework Convention (FCTC), ratified by Tunisia.

FT

[1] Ayedi Y, Harizi C, Skhiri A, Fakhfakh R. Linking Global Youth Tobacco Survey (GYTS) data to the WHO Framework Convention on Tobacco Control (FCTC): The case for Tunisia. Tobacco Induced Diseases. 2022;20(January):7. doi:10.18332/tid/143994.