Term of Award

Fall 2023

Degree Name

Doctor of Public Health in Epidemiology (Dr.P.H.)

Document Type and Release Option

Dissertation (restricted to Georgia Southern)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Department of Biostatistics, Epidemiology, and Environmental Health Sciences

Committee Chair

Yelena Tarasenko

Committee Member 1

Hani Samawi

Committee Member 2

Logan Cowan


This study examined (1) changes in tobacco use and related behaviors, including tobacco use in schools, anti-tobacco education and cessation efforts among youth over time and (2) potential contribution of cessation support and anti-tobacco education to quit attempts among youth. Data from the latest two rounds of the Global Youth and Tobacco Survey (GYTS) for adolescents aged 13-15 were used. Specifically, 10 countries met the inclusion criteria for examining changes in use of tobacco products and nicotine dependence; 45 countries met the inclusion criteria for investigating changes in quit attempts; 42 for receipt of cessation support; 28 – for anti-tobacco education; 27 – for tobacco use in schools, and 46 – for the combined analysis on the association between cessation support and anti-tobacco education with quit attempts. To assess differences between the GYTS rounds, crude and adjusted prevalence estimates were compared as average adjusted predictions from univariate and multivariate logistic regressions. The association between quit attempts and other characteristics were examined using mixed effects binary logistic regression with random intercept for country. As hypothesized, cigarette smoking has decreased while e-cigarette and dual use have increased. Cessation support and anti-tobacco education are positively associated with quit attempts of adolescents, yet cessation initiatives for youth, especially those for novel tobacco and nicotine products, are lacking in many countries. Continuous monitoring of these indicators is necessary to help guide the development of public health interventions for youth to curtail their tobacco and nicotine product use.

Research Data and Supplementary Material


Available for download on Sunday, November 12, 2028