BMC Public Health 2008, 8(Suppl 1):S4 http://www.biomedcentral.com/1471-2458/8/S1/S4 your presence, in places other than your home?”); one or more parents smoke cigarettes (based on a response of “both”, “father only”, or “mother only” to the question, “Do your parents smoke?”); one or more best friends smoke cigarettes (based on a response of “most” or “all” to the question, “Do most or all of your best friends smoke?”); in favor of banning cigarette smoking in public places (based on a positive response to the question, “Are you in favor of banning smoking in public places (such as in restaurants, in buses, streetcars, and trains, in schools, on playgrounds, in gyms and sports arenas, in discos?”); and exposure to pro-tobacco advertising and promotion, either direct or indirect (based on: a response of “a lot” or “a few” to the questions, “During the past 30 days (1 month), how many anti-smoking media messages (for example, television, radio, billboards, posters, newspapers, magazines, movies, drama) have you seen or heard?”, “During the past 30 days (1 month), how many advertisements for cigarettes have you seen on billboards?”, “During the past 30 days (1 month), how many advertisements for cigarettes have you seen at point of sale?”, “During the past 30 days (1 month), how many advertisements or promotions for cigarettes have you seen in newspapers or magazines?”; a positive response to the questions, “Do you have something (t-shirt, pen backpack, etc) with a cigarette brand logo on it?” or “Has a cigarette company representative ever offered you a free cigarette?”). The GYTS data in this report include a representative national estimate, compiled from 10 separate surveys conducted in Turkey in 2003: three major cities (Ankara, Istanbul and Izmir) and seven geographical regions (Aegean, Marmara, Black Sea, Mediterranean, Inner Anatolia, Eastern Anatolia, and South-Eastern Anatolia). In total, 15,957 students completed the GYTS. The GYTS sample design produces representative, independent, cross-sectional estimates for each site. A weighting factor was applied to each student record to adjust for the probability of selection at the school, class, and student levels, and non-response at the school, class, and student levels. A final adjustment sums the weights by grade and gender to the population of school children in the selected grades in each sample site. Thus, the national data are a compilation of the individual site data. SUDAAN, a software package for statistical analysis of correlated data, was used to compute standard errors of the estimates and produced 95% confidence intervals, which are shown in the manuscript as lower and upper bounds [9]. t-Tests were used to determine differences between subpopulations [10]. Statistical differences are noted at the p < 0.05 level. Given that gender is an effect modifier for the association between smoking and various risk factors [11,12], all statistical analyses were conducted stratifying on gender. This paper is limited to students aged 13 to 15 years old. The findings in this report are subject to at least three limitations. First, because the sample surveyed was limited to youths attending school, they may not be representative of all 13 to 15 year olds in Turkey. Second, these data apply only to youths who were in school the day the survey was administered and completed the survey. The school response rate was 100% in all sites. The student response rate was over 90% in all sites, except South-Eastern Anatolia (84.0%), suggesting bias due to absence or non-response is small. Third, data are based on self reports of students, who may under- or over-report their use of tobacco. The extent of this bias cannot be determined in this particular group; however, responses to tobacco questions on surveys similar to GYTS have shown good test-retest reliability [13]. Results Prevalence Almost 3 in 10 (26.3%) students in Turkey ever smoked cigarettes, with the rate for boys (31.7%) significantly higher than for girls (19.7%) (Table 1). Of ever smokers in Turkey, 30.7% initiated smoking before age 10, with a significantly higher rate among boys (34.9%) compared to girls (23.7%). Overall, 6.9% of students in Turkey currently smoked cigarettes, with again a significantly higher rate among boys (9.4%) compared to girls (3.5%). Overall, 3.4% of students currently used tobacco products other than cigarettes; the rate for boys (4.4%) was about 3 times the rate for girls (1.5%). Slightly over 1 in 10 (13.1%) students who currently smoked cigarettes reported they ”feel like having a cigarette first thing in the morning” (suggesting tobacco dependency). Among never smoker adolescents aged 13 to 15 years, 7.0% indicated that they were susceptible to initiate smoking during the next year (8.2% of boys and 5.3% of girls). Cessation Among students who currently smoked cigarettes in Turkey, over 6 in 10 students (65.3%) reported that they “want to stop smoking now”; 61.4% stated that they “tried to stop smoking during the past year but failed”; and 71.5% reported that they “had received help to stop smoking” (Table 1). Among current smokers, boys were significantly more likely than girls to have tried to stop smoking or to have ever received help to stop smoking. Exposure to secondhand smoke Over 8 in 10 students in Turkey reported that they were exposed to smoke from others in their home (81.6%) and in public places (85.9%) (Table 2). Over 9 in 10 (91.4%) students in Turkey thought “smoking should be banned in public places”; support rates were significantly higher among girls (94.0%) than among boys (89.6%). Page 3 of 7 (page number not for citation puroposes)