Using the Global-School-Based Student Health Survey to Identify Correlates of Smoking in Chilean Youth

Introduction It has been reported that Chile has among the highest youth tobacco smoking prevalence in the world. The Global Youth Tobacco Survey (GYTS), conducted from 1999 to 2001, reported that youth in Chile had the highest rate of smoking among youth in 43 countries around the world and the highest of the 24 countries in the Region of the Americas. (1) Youth smoking prevalence (current smoking) among students enrolled in schools aged 13-15 ranged from 36.1% in Valparaiso to 38.4% in Santiago and 39.6% in Coquimbo. The overall median per cent of current smoking across the 43 countries in the GYTS was 13.9%, so the prevalence rate in Chile was almost three times the median rate globally for the countries involved in the survey. More recent analysis of GYTS data collected from 140 countries between the years of 2000-2007 showed that there were only 8 countries where 30% or more of the youth 13-15 years old smoke, and Chile was among those countries. (2) In fact, only youth in the Cook Islands and Papua, New Guinea smoked at a higher prevalence than the Chilean youth. The specific data representing Chile in the GYTS cross-national study was from students in Santiago, where it was found that 33.9% of the students smoked cigarettes in the past month (current smoking). A much higher percent of the Santiago girls (39.2%) reported smoking than boys (27.5%). Chile's Ministry of Interior reports that among youth 12-18 years of age that current smoking fell from 27.1% in 1994 among males to 25.6% in 2004, but increased from 21.1% to 25.9% over the same years. (3) According to Araneda and Cumsille, among students in primary (basico) grade 8[degrees] through secondary (medio) grade 4[degrees] in 2003, 35.1% of males and 40.8% of female reported current smoking. (4) Current smoking was reported among students by 24.0% of primary grade 8[degrees], 33.1% of secondary grade 1[degrees], 41.4% of secondary grade 2[degrees], 47.9% of secondary grade 3[degrees], and 51.8% of secondary grade 4[degrees]. The 38% of students who smoke in Chile in these grades is much higher than the 28.8% of students in Spain and 24.3% in the U.S. of comparable age who smoked cigarettes in the same year (2003) These data from Spain are from its Ministry of Interior and for the United States are from the Monitoring the Future Study. (5,6) Unfortunately, data on youth smoking prevalence in Chile in the international literature is limited to the data reported above. More studies are needed to determine if these high rates of smoking have continued beyond 2004 and whether prevention programming has impacted the high smoking rates reported in 2004 and earlier. In August 2006, Chile enacted new legislation that set strict regulations on cigarette advertising. (7) The new law banned tobacco advertising in the media and near schools, as well as prohibiting the selling of cigarettes to minors with in a 100-meter radius of schools. Further, the legislation prohibited smoking in many public places and the mandating that all cigarette packs carry warnings that take up half of both sides of the pack. According to Bonnefoy, smoking prevention in Chile is weak and although some education programs geared at students have been implemented, they are not extensive or coupled with public information campaigns. (7) Also, prevention measures and the effects of new anti-smoking laws in Chile have not been measured. Unfortunately, there is also evidence that since the early 1990s, multinational tobacco companies have promoted "youth smoking prevention" programs widely throughout Latin America, and even partnered with education and health ministries in several countries in doing so. (8) In response to the high smoking prevalence in this nation, Caris et al. (9) advocate for research investigating characteristics of Chilean youth smokers because this research "may give clues as to what public health measures might be more or less effective in reducing the tobacco-smoking prevalence in both Chile and other nations" (p. …