Single and multiple tobacco/nicotine product use among Serbian youth
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Institute of Public Health of Serbia, Serbia
Association "Health Mission"
Institute of Social Medicine, Faculty of Medicine, Belgrade University, Serbia
Institute for Medical Statistics and Informatics, Faculty of Medicine, Belgrade University, Serbia
Publish date: 2019-03-26
Tob. Prev. Cessation 2019;5(Supplement):A2
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Concurrent use of tobacco products is associated with increased risk of nicotine dependence and smoking-related complications. Increase in dual and poly tobacco product use worldwide represents a significant public health problem and call for better understanding of patterns of multiple product use. The aim of our study was to explore the pattern of use of cigarettes, waterpipes and e-cigarettes in youth in Serbia.

Method This is a secondary analysis of cross-sectional data obtained through the Global Youth Tobacco Survey (GYTS) conducted in Serbia in 2017. A two-stage cluster sample design was used to produce a representative sample of students 13-15 years old. In total 3362 students in this age group completed the questionnaire. Descriptive statistic was used for presenting the frequency of different categories of students according to their tobacco products use status.

Among 13-15 years old students, current prevalence (at least once in the last month) of cigarette smoking was 11%, of waterpipe smoking 9% and of e-cigarette use 6.2%. The most common pattern of current tobacco/nicotine use was waterpipe and/or e-cigarette use with no cigarette smoking (7.5%), followed by exclusive cigarette use (5.8%). Among student in the seventh grade of primary school, e-cigarette and/or waterpipe tobacco smoking was threefold higher (7.5%) than exclusive cigarette use (2.5%). Regarding current cigarette smokers, more than half are exclusive cigarette smokers (52.8%). Among all e-cigarette users, 39.3% are exclusive e-cigarette users, while 45.7% of current waterpipe tobacco smokers use this product exclusively.

The current prevalence of waterpipe and/or e-cigarette use is more common than exclusive cigarette smoking. This can be, among others, explained by lack of knowledge on these products and consequences of use as well as with curiosity. Finding calls for awareness raising campaigns and inclusion of waterpipe and e-cigarette related topics in the curriculums of evidence based interventions.

University of Illinois at Chicago’s Institute for Health Research and Policy through its partnership.