FACT SHEET - Health Promotion : Vol. 2 No. 2 November 1998 Smoking Behavior of Thai Youths Thailand Dr. Choochai Supawongse et al, Senior Environmental Health Advisor, Office of Technical Advisors, Department of Health This study intended to explore the behavior of Thai youths in 16 provinces including Bangkok, and their condition related to tobacco smoking by using systematic sampling. It investigated the typical patterns of their behavior development and attitude relating to tobacco uptake and disclosed significantly associated factors such as individual, family status, environment, and health warning labels towards uptake of the youths and regulation measures which prohibited children under 18 smoke. It presented the analysis on relationship in relative risk, not in causal relationship, which was not only descriptive but also explanatory in order to show the essential factors associated with smoking behavior among Thai youths which would lead to policy formulation and direct intervention. The highlight of the study was the target group which included both in-and out-ofschool youths, of which 20% were out of school system and were in labour force. The target group was divided into four groups as: 510 males and 1,862 females of aged 15-17, 529 males and 2,533 females of aged 20-24 years who came to apply for ID card in April 1997, which was in the school vacation period, and most people liked to apply for ID card. The ratio of male and female youth was 1:4. Smoking condition was divided into 3 categories: 1) regular smokers, 2) occasional smokers (including ever smoked and now quitted, and experimenters), and 3) never smokers. Results of the study 1. Situation of minors smoking. The study reported that 15 years old males, slightly more than one-third (35.7%) had ever tried a cigarette whereas about one-tenth (9.3%) of females did so. They had tried the first few puffs at the age of 13-14 and at the age of 15, about 22.5% of both male and female youths were smokers (regular smokers, occasional smokers, ex-smokers and experimental smokers). Among these youths, 9.3% of males and 0.7% of females had already become regular smokers. For the youths aged 22, 39.2% of males and 2.2% of females were regular smokers. The most reason for smoking was just try for fur. Some said that they started smoking because they felt lonely and insecure. Most of youth smokers (more than 90%) wanted to quit smoking and two-thirds had tried to quit but failed. 2. Factors related to smoking behavior 2.1 Socio-economic and educational factors. It was clearly found that males and females aged 15 and 22 who smoked regularly were more likely to have poor educational performance, low education and early school dropouts than non-smoking youths. On the other hand, the non-
smokers had planned to further their higher education more than regular smokers (see Table 1 and 2). Moreover, it was also found that the more income the youths had, the higher rate of smoking was. 2.2 Individual and family factors. The study showed that the regular smokers were more likely to have gloomy families with greater chance of assaults and abused, have drunkard and gambler as a family member. Moreover, regular smokers were 4 times more likely to be ever attacked by family members than non-smokers. Smoking behavior of parents, elder siblings and friends had an impact on smoking behavior of youths. Mothers had more influence on daughters than sons especially in age 15. However, closest friends who drank spirits and ever tried narcotic drug had much influence on both male and female smokers. (see Table 3 and 4)
3. Attitude Never-smokers had negative attitude toward smokers. Especially female smokers were seen as suppressed and inferior. 4. Effect of health warning labels About 30.1 percent of smokers said the warnings made them rethink and 42.0% of non-smokers said the warnings made them not to smoke. They believed that the warning labels on cigarette package due to the law can prevent youths from trying smoking. 5. Effect of Tobacco-control Laws that bans sell to minors It was found that 96.7 of vendors sold cigarettes to minors under 18 years (see Table 5). However, the majority of youths (90%) supported the tobacco-control law that are not allowed to sell cigarettes to youths aged under 18.
Recommendations 1. Policy and strategies on tobacco control especially for the youths aged 12-25, both in- and out-of-school systems should be stipulated. 2. Measures and preventive mechanism to prevent youths in the compulsory education from smoking and then addict to them should be developed and should be expanded the compulsory education system to 9 years which may reduce the smoking rate of the minors. 3. The enforcement of the law "Tobacco-control Act 1992" which bans sale to minors under 18 is not fully practiced. The law should be more enforced by increasing the penalty of the vendors. 4. Information should be regularly disseminated to public through the year round to every mass media that could reach male and female youths. 5. Develop curriculum and produce handbook on no smoking to campaign for minors. 6. Peer groups should be set up to increase and develop students' life skills for denying smoking or any narcotic drug. Students could monitor smoking and selling cigarettes to minors under 18. 7. NGOs should be supported to collaborate campaign on no smoking, especially in the part which NGOs can do more effectively. R E F E R E N C E Choochai Supawongse, Supakorn Buasai, Nuan-Anan Tantigate Smoking Behavior of Thai Youths, Supported by Institute of Tobacco Control, Department of Medicine, Ministry of Public Health, 1997