Campus Policy on Tobacco Prohibition and Tobacco Use among Youth in Sub-Saharan Africa: An Investigation Based on the Perspectives of School Personnel

Abstract

Background

Schools in sub-Saharan Africa respond to the widespread use of tobacco among youth with the tobacco-prohibition policies. This study empirically examined the impact of the strength of campus tobacco-prohibition policies on tobacco use among youth across 20 sub-Saharancountries.

Methods

This study used data from the Global School Personnel Survey across 20 sub-Saharan countries during 2005–2011. Respondents comprised 7,365 school personnel (valid sample size) from Cameroon, Central African Republic, Congo, Eritrea, Ghana, Guinea-Bissau, Lesotho, Malawi, Mauritania, Mauritius, Namibia, Niger, Rwanda, Senegal, Seychelles, Sierra Leone, South Africa, Swaziland, Togo, and Uganda. Considering the potential endogeneity-estimation bias occurring in the normal ordinary least square estimation, instrumental variable estimation was used to ensure the regression results were reliable.

Results

The interaction term “tobacco-prohibition policy × policy-enforcement strength” was found to negatively predict perceived seriousness of tobacco use among youth (−0.0053, 95% CI [-0.0101, -0.0005]; p<0.05), which indicated that when campus tobacco-prohibition policy and enforcement were both sufficiently strict, the extent to which school personnel felt concerned or anxious about tobacco use among youth in the 20 countries was lowest. A series of identification tests using instrumental variable estimation demonstrated that these regression results were reliable and without endogeneity-estimation bias.

Conclusion

This study confirms the effectiveness of the interaction of tobacco-prohibition policy and policy-enforcement strength for alleviating the seriousness of tobacco use among youth in underdeveloped areas. A series of important policy implications are discussed to prevent fast development of tobacco use in this area.

Keywords:

• tobacco-prohibition policy
• tobacco use
• sub-Saharan African countries
• youth

Ethics

This study did not involve human/animal subjects or require any ethical approval.

Disclosure

The authors declare no conflicts of interest for this work.

Additional information

Funding

We appreciate the support from the National Natural Science Fund of China (41571129) and the Social Science Fund of Guangdong Province (Grant No. GD19YTY03).