Adolescent Smoking in PNG

Papua New Guninea, like so many countries in the world today face growing numbers of adolescents who take up tobacco smoking

But why should we be concerned? Well the World Health Organisation reports that the use of tobacco is the leading preventable cause of death in the world with more than 5 million people worldwide dying from tobacco use annually (WHO 2009a). It also says that the burden of tobacco use is greatest in low and middle-income countries and is predicted that, if very little is done to curb tobacco use and current trends continue, tobacco use will kill more than 8 million people worldwide each year by the year 2030, with 80% of these premature deaths in low-and middle-income countries (WHO 2009a; Anderson Johnson et al. 2006; Devlin, Eadie, and Angus 2003).

According to the PNG National Statistics Office, from the 1990 Census, the projected number of young people in 2010 would stand at 1,243,138 who are aged between 10-19 years old and they would make up 22.6% of the total population (NSO 2004). So this means that 2 out of every 10 people in PNG today, is aged between 10-19 years old. This age group of young people are at a time of transition from childhood to adulthood and are most vulnerable to developing smoking habits that lead up to adulthood (Mitchell, Rosenberg, and Wood 2008).

As experienced in other countries, adolescents in Papua New Guinea can be vulnerable to the tobacco use due to factors such as stress (Byrne, Byrne, and Reinhart 1995; Anderson Johnson et al. 2006), sensation seeking (Urban 2010), experimentation, peer use and peer perception (Krisjansson et al. 2010) or even with parents smoking (Melchior et al. 2010; Hiawalyer 2002).

• Prevalence of tobacco use
Although there has been little done to find the prevalence of tobacco smoking among this age group of 10-19 year olds in Papua New Guinea, WHO statistics show 43.8 percent of young people in PNG aged 13 to 15 years old were reported to ‘currently smoke tobacco products’ (WHO 2009d) and in that same age group, the current cigarette use prevalence among boys which is 52.1%, is considered as the highest in the Western Pacific Region (CDCP 2008).

A significant research which was carried out by Gilbert Hiawalyer from the National Health Department, exemplified the grave situation on tobacco’s impact on adolescents in the country. His research on 3,000 young people aged 8-20 years in Manus and Central province showed that young children, as young as 8 years of age had began smoking. He also found that out of the 2000 adolescents in NCD, the capital city of PNG, only 10% of the males and 37% of the females were non smokers and proportionally, there was an average of two male smokers to one female smoker (Hiawalyer 2002).

Table 1 Smoking prevalence by age group

In Manus province, which is the smallest province in PNG in terms of population and land area, Hiawalyer found that of the 1,000 boys and girls he interviewed, 5% of the males and 40% of the females were non-smokers. From 2,245 smokers, he also found that the number of smokers increased with age. This, he described, was that as he moved higher in the grade levels, the number of smoker also began to increase. His study also found that smokers were influenced by their friends, parents and the media respectively (Hiawalyer 2002).

Table 2 Factors influencing smokers to smoke

Another study carried out by final year students of Divine Word University on 200 children in five primary school in the Madang Urban District found that 18% regarded themselves as smokers while 10% of them smoked three to four times daily (Ongogo, Gabuogi, and Varip 2010). The DWU researchers also found that 63% of the smokers were aged 13-15 years old, 30% were between the ages of 16-18 while 7% of these primary school children aged between 10-12 years old smoked (Ongogo, Gabuogi, and Varip 2010).

• Tobacco Uptake Factors
The Global Youth Tobacco Survey, which is a school based survey aimed at finding data on smoking among 13-15 years olds, indicates that the environment is a significant factor in young people’s uptake of tobacco products (CDCP 2007) and adolescents in PNG are no exception (Hiawalyer 2002). The environment may include family and social support networks who can influence adolescents’ smoking uptake (Mermelstein 2003).
For example, Onguglo, Gabuogi and Varip (2010) found that although 49.5% of the 200 students in Madang five primary schools indicated in a questionnaire that they knew that smoking caused lung cancer, 53% of total students who smoked said they did so because of peer pressure.

The home where a family lives can also influence smoking habits (Betson et al. 1995; Krisjansson et al. 2010). The GYTS done in PNG in 2007 also show that 73.9% of young people aged 13-15 years old are exposed to smoke at home (WHO 2009c) and Hiawalyer found that adolescents in NCD (34%) and Manus (39%) smoked because their parents did so at home (Hiawalyer 2002).

The low cost of tobacco products in Papua New Guinea is also a factor for adolescent up take of tobacco (PNGMOH 2004). An example of this would be the smoking of the ‘roll your own’ (RYO) tobacco that is being sold on almost every street corner. The situation in PNG, as in Malaysia and Thailand, the ‘Roll your own’ tobacco use is associated with living in rural areas, older average age, lower level of education, male gender, not being in paid work, slightly lower consumption of cigarettes, higher social acceptability of smoking, and positive attitudes toward tobacco regulation (Young et al. 2008). This also holds true for the PNG situation but the RYO cigarette has significantly increased in urban areas and has popular among adolescents that are in school or out of school and do not work (Lipset 2005).

This is because it is the cheapest of all tobacco products in this country as it is home grown and sold locally (FCTC Convention Secretariat 2010). It costs 10t (5 Australian cents) for one stick, isn’t taxed and carries no health warning (FCTC Convention Secretariat 2010).

Another example of cheap tobacco products would be that of the practise of selling loose cigarettes. Factory made cigarettes that come in packs of 20 that cost K11.40 are sold individually at roadside markets for 70 toea. This practise of buying single or loose cigarettes is cheaper than paying for a whole pack of 20s and young people can easily afford this factory made cigarettes for a fraction of the total price.

.........In my next post, I will highlight what WHO's Framework Convention on Tobacco Control (FCTC) means to PNG and how we can do to minimise smoking rates among adolescents.