Current Cigarette Smoking and Its Predictors among School-Going Adolescents in East Africa: A Systematic Review and Meta-Analysis

BACKGROUND: In developing countries, tobacco smoking has its own contribution to the burden of noncommunicable causes of morbidity and mortality. Studies estimated the burden of cigarette smoking among school-going adolescents in different geographical areas of East Africa. However, due to discrepancies found among those different findings, there is no representative data about the burden of smoking in the continent. OBJECTIVES: This systematic review and meta-analysis aimed to assess the pooled prevalence of current cigarette smoking and its associated factors among school-going adolescents in East Africa. METHODS: PubMed, Google Scholar, and the Web of Science Library were searched to access included articles. A weighted inverse-variance random-effects model was used to estimate the prevalence of current cigarette smoking. Variations in the pooled estimates of the prevalence were adjusted through subgroup analysis according to the specific country, where the study was conducted. Funnel plot and Egger's regression test were used to check publication bias. STATA version 14 statistical software was used for meta-analysis. RESULTS: A total of 26,875 school-going adolescents were included. The pooled prevalence of current cigarette smoking among school-going adolescents in East Africa was found to be 9.02% (95%CI: 6.34-11.70). Based on the subgroup analysis, current cigarette smoking among school-going adolescents was estimated at 9.8% in Kenya, 7.72% in Ethiopia, 10.83% in Uganda, 13.6% in Sudan, and 4% in Tanzania. CONCLUSIONS: This meta-analysis revealed that the prevalence of current cigarette smoking is increasing among school-going adolescents in East Africa. Therefore, countries have to realize sale prevention policies, establishing and/or strengthening antismoking campaigners designed for school-going adolescents, and providing training for teachers to be antismoking campaigners.