S.: n=step onestep step three,689) split up from the attempt measurements of for every country multiplied by the amazing weights

According to the complex sampling design of the GYTS, the weighted prevalence estimates and their 95% confidence intervals (CI) of smokeless tobacco use in each country were calculated using original sampling weights, strata, and pripling units provided in the datasets using the SAS PROC SURVEYFREQ procedure. The original weights were calculated by the following formula: W=W₁*W₂*f₁*f₂*f₃*f_cuatro, where W₁ is the inverse of the selection probability of each school; W₂ is the inverse of selection probability of each class; f₁ is the school-level non-response adjustment factor calculated by school enrolment size; f₂ is the class-level non-response adjustment factor for each school; f₃ is the student-level non-response adjustment factor for each class; f₄ is the post-adjustment stratification factor calculated by grade and sex. We rescaled the original weights to calculate the overall and subgroups‘ prevalence of smokeless tobacco use based on each country’s sample size. The rescaled weights were calculated as the maximum country sample size (i.e., U. Chi-square trend test was used to examine the secular trend in the prevalence with consideration of data from all surveys in each country between 1999 and 2019. The prevalence estimates of secular trends were calculated per 5 calendar years. Multivariable logistic regression models were used to assess the association of potential associated factors (sex, age, cigarette smoking, other tobacco product use, parental smoking, smoking status of closest friends, tobacco advertisement exposure, being offered free tobacco products, being taught about dangers of smoking, and World Bank income level) with current smokeless tobacco use, and the code for each variable is shown in Additional file 1: Table S1. In order to correct the overall probability of type I error in multiple statistical tests (?=0.05), the Bonferroni’s correction was used to adjust the critical significance level of each statistical test. The corrected critical significance level was equal to the original critical significance level (0.05) divided by the number of tests performed. A two-sided P-value less than the Bonferroni’s corrected critical significance level was regarded as statistical significance and SAS 9.4 (SAS Institute, Cary, NC, US) was used for all analyses.

Abilities

A total of 450,691 kids (boys: 51.4%) old several–16 decades from 138 countries surveyed anywhere between 2010 and you may 2019 was included so you’re able to estimate the newest frequency away from most recent smokeless cigarette smoking and you can the relevant circumstances. Among 138 included regions interviewed in 2010–2019, 23 (sixteen.7%) was basically in the African area, 30 (21.7%) about American region, 23 (16.7%) regarding the Eastern Mediterranean part, 29 (twenty two.5%) throughout the Eu area, nine (6.5%) about South-Eastern Asian area, and you will twenty-two (15.9%) on the Western Pacific region (More document step 1: Dining table S2).

Based on the newest investigation off 138 regions this year-2019, the general incidence of current smokeless cigarette smoking was 4.4% (95% CI 4.0–4.9), having 5.7% (5.1–six.3) for guys, 3.1% (dos.6–step three.5) for girls, step three.9% (step three.5–4.4) having kids old several–14 many years, and you can 5.4% (cuatro.8–5.9) for these old 15–sixteen many years (Desk step 1). The brand new frequency ranged notably all over the 138 countries (regarding 0.0% inside Tokelau so you’re able to 51.6% in the Kiribati), by sex and age group contained in this all of really countries (Fig. step one, and additional document step one: Fig. S2 and you can Desk S3). The incidence try nearly 5 times higher one of most recent smokers compared with low-smokers (fourteen.3% against. step 3.0%), and you may almost 7 times higher certainly other cigarette product users compared which have non-pages (22.5% vs. step 3.2%). The new prevalence certainly kids whoever both parents (nine.8%), and you will mommy only (5.6%) smoked are higher than people whoever father just (cuatro.4%) and you may neither moms and dad (4.7%) used. The fresh frequency are highest on South-East Western part (six.1%), with the new African part (5.4%), and lowest about West Pacific area (dos.0%). The latest incidence try higher within the all tinder web the way down-middle-earnings regions (5.5%), followed by reduced-income places (cuatro.7%), and you can lower in high-income places (dos.8%) (Table step one).