The relationship between proximity of tobacco retail outlets to schools and tobacco use among school personnel in sub-Saharan Africa

Background. We investigated the impact of proximity of tobacco retail outlets to schools on tobacco-related behavior and attitudes of school personnel in sub-Saharan Africa. Methods. A pooled analysis of the 2006-2011 Global School Personnel Surveys from 19 sub-Saharan African countries was performed (n = 12,201). Multivariate logistic regression analyses were applied to measure the relationship between proximity of tobacco outlets to school premises and school personnel's tobacco-related behavior and attitudes (p < 0.05). Results. Among all school personnel, there was a significant association between the presence of tobacco outlets on school premises and current cigarette smoking (adjusted odds ratio [aOR] = 3.89; 95% confidence interval [Cl]: 2.17-7.20), current smokeless tobacco use (aOR = 2.63; 95%Cl: 1.04-6.65), and permissiveness towards tobacco industry sponsorship activities in school (aOR = 227; 95%Cl: 1.37-3.78). Complete smoke-free school policies were associated with lower odds of current cigarette smoking (aOR = 0.42; 95%Cl: 0.23-0.74), but were not significantly associated with current smokeless tobacco use. Among lifetime any tobacco users, there was a significant association between the presence of tobacco outlets on school premises and use of combustible (aOR = 2.03; 95%Cl: 1.09-3.75) and smokeless (aOR = 3.85; 95%Cl: 1.51-9.81) tobacco products on campus within the past year. Conclusions. Policies limiting the distance of tobacco outlets from schools, coupled with complete tobaccofree school policies may reduce tobacco use among school personnel. (C) 2014 Elsevier Inc. All rights reserved.