Linking Global Youth Tobacco Survey (GYTS) Data to the WHO Framework Convention on Tobacco Control (FCTC): The Case for the Seychelles☆
Introduction
Tobacco control has been an important public health concern in Seychelles for the past two decades. This focus resulted from high-profile awareness campaigns for tobacco control since the late 1980s, commitment to tobacco control of several key players and policy makers, particularly in the Ministry of Health and in the mass media, and early establishment of a focal point for tobacco control that allowed coordination of various nationwide activities. Seychelles participated actively in the intergovernmental negotiations for the Framework Convention on Tobacco Control (FCTC) and Seychelles was the first country in the African region to ratify the treaty in November 2003. The FCTC, which is the world's first public health treaty on tobacco control, calls on countries to develop and implement comprehensive national tobacco control action plans and policies, such as bans on direct and indirect tobacco advertising, sponsorship and promotion, appropriate tax measures on tobacco products, promoting smoke-free public places and workplaces, and placing health messages on tobacco packaging (WHO, 2003).
A number of tobacco control measures have been in place in the Seychelles for years (Bovet, 2001). Since colonial times (before 1976) smoking was completely banned on public transport (i.e., buses). By directive in 1994, the Minister of Health (MOH) issued a complete ban on smoking in the outside and inside premises of all health facilities. Smoking is also banned in the outside and inside premises of all schools. In 1999, the national airlines company “Air Seychelles” prohibited smoking on domestic and international flights. For the past decade, tobacco advertising has been banned on national TV and radio, in local newspapers and magazines, and on billboards and outdoor walls, and this ban is fully implemented. Vending machines that sell cigarettes cannot be found in Seychelles. In 2001, the Children Act of 1998 (section 73) was amended to include a ban on the sale of tobacco products to anyone under the age of 18 years. Annually, the MOH conducts community awareness programs on “Tobacco or Health” and high profile nationwide activities for World No Tobacco Day, including a press release and a message by the Minister of Health or other high officials. In 2000, the MOH established a multi-sectoral National Committee for Tobacco Control to develop a comprehensive tobacco control plan and a smoking cessation program to be presented to the Government. This Committee, in collaboration with national and international experts, has finalized a draft for a comprehensive Tobacco Control Bill, which is highly compliant with the FCTC and is now scheduled to be presented to the National Assembly.
One important provision of the FCTC is the obligation for countries to establish programs for national, regional, and global surveillance (WHO, 2003). The World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), and the Canadian Public Health Association have developed the Global Tobacco Surveillance System (GTSS) to assist WHO Member States in establishing continuous tobacco control surveillance and monitoring (Global Tobacco Surveillance System Collaborating Group, 2005). The GTSS includes collection of data through three surveys: the Global Youth Tobacco Survey (GYTS) for youth, the Global School Personnel Survey (GSPS) and the Global Health Professional Survey (GHPS) for selected adult target groups.
The Global Youth Tobacco Survey (GYTS) uses a standardized methodology for constructing sampling frames, selecting schools and classes, preparing questionnaires, carrying out field procedures, and processing data. The GYTS questionnaire is self-administered in classrooms and school, class, and student anonymity is maintained throughout the GYTS process. Country-specific questionnaires consist of a core set of questions that all countries ask as well as a set of unique country-specific questions. The final country questionnaire is translated in-country into local languages and back-translated to check for accuracy. GYTS country research coordinators conduct focus groups of students aged 13–15 to further test the accuracy of the translation and student understanding of the questions.
The purpose of this paper is to present data from the GYTS conducted in Seychelles in 2002 and to elaborate on how it can serve as an instrument for monitoring and strengthening tobacco control programs and policies nationally. In particular, we present data on the prevalence of direct or indirect exposure to tobacco smoke and selected factors influencing tobacco use (e.g. exposure to media and advertising, access and availability of tobacco products, tobacco-related school curricula) and we relate these findings to existing or needed programs and policy.
Section snippets
Methods
The Global Youth Tobacco Survey (GYTS) uses a two-stage cluster sample design that produces representative samples of students in grades associated with ages 13–15 years. The sampling frame includes all schools containing any of the identified grades. At the first sampling stage, the probability of schools being selected is proportional to the number of students enrolled in the specified grades. At the second sampling stage, classes within the selected schools are randomly selected. In the
Prevalence
Half of the students (50.6%) in Seychelles reported that they had ever smoked cigarettes, even one or two puffs (Table 1). Almost a fifth of the students (18.9%) reported that they initiated smoking before the age of 10 years. Approximately a quarter of students (26.8%) were “current smokers” (i.e. smoked at least 1 cigarette on at least 1 day during the past 30 days), with no statistical difference between boys and girls. Among never smokers, 16.5% indicated that they were susceptible to
Discussion
Some main findings can be singled out. First, approximately half of the students aged 13–15 years have tried smoking and a quarter reported current smoking (i.e. smoking at least one cigarette during the past 30 days) and these proportions were not different between boys and girls. Second, a majority of children reported to be exposed to second hand smoke. Third, 62% of students reported having seen tobacco advertising. Fourth, as many as 23% of under-aged smokers reported purchasing cigarettes
Conflict of interest
The authors have no conflict of interest to declare.
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Statement: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions.