2002-12-31-世界卫生组织-2003_GYTS_Country_Report_Georgia_19页_142kb

Introduction

• Tobacco use is a major preventable cause of death globally, contributing to millions of deaths annually, with higher future projections in developing countries.
• In Georgia, adult smoking rates are stable but show significant gender disparity (over 50% men smoke vs. ~15% women). While overall youth smoking prevalence is moderate, concerns exist about potential increases, necessitating surveillance. Existing tobacco legislation is underdeveloped and lacks full alignment with international frameworks.
• Georgia is a significant tobacco producer and manufacturer. The survey was conducted following an invitation to participate in the WHO European GYTS project by 2002.

Methods

• The GYTS 2002 in Georgia was a school-based survey using a two-stage cluster sampling design targeting 7th, 8th, and 9th graders to achieve a nationally representative sample. Data collection involved anonymous, voluntary completion of self-administered questionnaires using multiple-choice questions during classroom sessions.

Results - Key Findings

1. Tobacco Use Prevalence:

   • Overall, 43.9% of students had ever smoked cigarettes, and 22.1% were current cigarette smokers.
   • Male students were significantly more likely to have ever smoked and to smoke currently compared to their female peers (Boys: Ever Smoke ~55.5%, Current Smoke ~32.6%; Girls: Ever Smoke ~32.7%, Current Smoke ~12.1%). Rural areas also showed significantly higher current smoking rates than the capital city, Tbilisi (e.g., Rural 32.5% vs. Tbilisi 13.7%).
   • Almost half (52.2%) of ever-smokers initiated smoking before the age of 10, especially in other urban and rural regions.

2. Use of Other Tobacco Products:

   • Overall, 6.6% of students used tobacco products other than cigarettes in the past year.

3. School Education:

   • Only 10.4% of students reported having classes specifically teaching the dangers and effects of smoking or discussing reasons for youth smoking, varying significantly by region (Tbilisi: ~17%, Other Urban/Rural: ~2-4%).

4. Cessation Behaviors:

   • Of current smokers, 49.0% had tried to stop smoking in the past year, 41.2% expressed a desire to stop, and 57.5% reported receiving advice to quit. A small minority (2.3%) were considered dependent, as they smoked first thing in the morning.

5. Environmental Tobacco Smoke (ETS):

   • Exposure to ETS was extremely high among youth in Georgia (~90%) regardless of smoking status (never vs. current), gender, or region.
   • Boys and younger students were more often exposed to ETS at home (brothers, friends) compared to girls and older students.
   • Current smokers faced four times more ETS exposure at home from siblings and five times more from best friends than never-smokers.

6. Media, Advertising, and Availability:

   • Pro-tobacco advertising was dominant on all major media platforms (TV, radio, billboards, newspapers, cinema) (~70-80% saw pro-tobacco messages, only ~30% saw anti-tobacco messages on radio).
   • Exposure to tobacco logos (own items) or offers for free cigarettes was slightly higher among current smokers than never-smokers but overall relatively low (especially compared to Tbilisi).

7. Access and Availability:

   • Over half (53.0%) of current smokers bought cigarettes in stores, and most (97.1%) were not refused purchase due to age, despite the legal minimum age being 18.

Discussions, Conclusions, and Recommendations

• Tobacco Use: Youth smoking patterns mirror adult trends, with high male prevalence and concerning high use among rural youth. While decline is considered stable, maintaining low female rates is crucial, especially regarding comparison to European peers.
• Other Tobacco Products: Current consumption is low, but regulations are needed to prevent growth.
• School Education: Significantly expanding comprehensive tobacco control education in schools is necessary.
• Cessation: Public reporting desire and past quit attempts are high. Preventing relapse requires professionally-run cessation programs, ideally accessible in schools or via public health services.
• ETS: High exposure, especially among current smokers, highlights the need for stricter, enforceable regulations on smoking in homes and public places. Targeted programs addressing exposure at home are recommended.
• Media: Strict legislation banning all forms of tobacco advertising, promotion, and sponsorship (including indirect promotion) is urgently needed. Anti-tobacco advertising funding should be increased.
• Access: Enforcement of laws prohibiting underage tobacco sales must be strengthened.

In conclusion, the GYTS findings underscore the pressing need for decisive action through the development and implementation of a National Tobacco Control Plan, incorporating the FCTC principles, prioritizing evidence-based countermeasures to tobacco use among Georgian youth, particularly focusing on cessation support, ETS reduction, advertising restrictions, and school-based prevention.