Tshewang Gyeltshen

Tshewang Gyeltshen

Doctoral Candidate in Global Health Policy, School of International Health, The University of Tokyo

Trends in Prevalence and Correlates of Tobacco Use Among School-Going Adolescents in Bhutan: A Secondary Data Analysis of the 2004–2019 Global Youth Tobacco Survey

Published in PLOS Global Public Health, 2024

This paper investigates the long-term trends and key correlates of tobacco use among Bhutanese adolescents using data from five rounds of the Global Youth Tobacco Survey (GYTS), conducted between 2004 and 2019 with 12,594 respondents aged 11–18 years. Despite Bhutan’s strong tobacco control legislation, results revealed a steady increase in overall tobacco use prevalence from 18.5% in 2004 to 27.3% in 2019, with smokeless tobacco use nearly doubling during this period.

Sex-stratified analyses showed consistently higher prevalence among males, while females exhibited slower but notable increases, especially in smokeless tobacco use. Multivariable regression analysis of the 2019 wave identified significant correlates of adolescent tobacco use, including:

  • Early age of initiation (<11 years, aOR 9.2; 13–16 years, aOR 12.8)
  • Betel quid (doma) use (aOR 3.3)
  • Peer influence (aOR 3.6)
  • Exposure to secondhand smoke (aOR 1.8)
  • Affordability of tobacco products (aOR 1.7)

The findings underscore the urgent need for targeted interventions in Bhutanese schools, with a particular focus on junior high school students who are at heightened risk. Despite legal restrictions, the persistence of black-market supply and cultural acceptance of betel quid chewing complicate tobacco control efforts.

The study concludes that adolescent tobacco use in Bhutan remains among the highest in the region, highlighting the importance of sustained surveillance, stricter enforcement, and culturally sensitive prevention strategies.

Read the full article here

Recommended citation: Gyeltshen T, Rahman M (2024) Trends in prevalence and correlates of tobacco use among school-going adolescents in Bhutan: A secondary data analysis of the 2004–2019 Global Youth Tobacco Survey. PLOS Glob Public Health 4(7): e0003544. https://doi.org/10.1371/journal.pgph.0003544
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