Household tobacco smoke exposure and smoking intentions among never-smoking adolescents in Latin America and the Caribbean: A cross-sectional study using GYTS data

INTRODUCTION Tobacco use causes over 8 million deaths annually worldwide. In Latin America and the Caribbean (LAC), 70% of smokers start before the age of 18 years, which may be influenced by family and social factors like smoking at home. This study assesses the association between home tobacco smoke exposure and smoking intention among never-smoking adolescents in LAC. METHODS This was an analytical cross-sectional study using secondary data from the Global Youth Tobacco Survey (GYTS), conducted between 2013 and 2021, in adolescents aged 13–15 years who reported never smoking. Data were collected using self-administered questionnaires. The independent variable was household tobacco smoke exposure in the past week and the outcome was smoking intention. Prevalence ratios (PR) with 95% confidence intervals (CI) were estimated using Poisson generalized linear models at regional and country levels, adjusted by sex and age. Forest plots were generated in R Studio. Analyses were performed in Stata v18.0, with significance at p<0.05. RESULTS Prevalence of home tobacco smoke exposure was 18.49%, and 13.02% reported an intention to smoke. No significant association was found regionally. Associations were identified in six countries: Chile (adjusted prevalence ratio, APR=1.78; 95% CI: 1.33–2.37; p<0.001), Barbados (APR=1.98; 95% CI: 1.16–3.40; p=0.014), Dominican Republic (APR=1.96; 95% CI: 1.21–3.17), Saint Lucia (APR=1.82; 95% CI: 1.05–3.18; p=0.035), Panama (APR=1.58; 95% CI: 1.12–2.23; p=0.012), and Uruguay (APR=1.77; 95% CI: 1.27–2.46; p=0.002). CONCLUSIONS While no association was observed between household tobacco smoke exposure and smoking intention at regional level, significant associations were identified in six LAC countries. These findings highlight the need for further research to better understand these relationships in specific sociocultural contexts and to generate evidence that may inform the design of future prevention strategies.