Smoking initiation among Gambian adolescents: social cognitive influences and the effect of cigarette sampling.

In this study, determinants of tobacco use among Gambian youths were examined. A cross-sectional school-based survey was conducted among 282 students, aged 14-18. The potential determinants were derived from the core constructs of the Theory of Planned Behavior and the ASE model. Moreover, various measures of knowledge and media influence were added to the research model. The results show that free cigarette offers by representatives of tobacco companies were mostly responsible for the difference between smokers and non-smokers. Other variables associated with smoking behavior were greater intention to smoke in the future, lower self-efficacy expectations regarding emotional situations, smoking behavior of the respondent's best friend, the mother having a job and the absence of other family members living in the house. Our study supports current efforts to prohibit tobacco advertising and promotions in The Gambia, especially the distribution of free samples. Additionally, we recommend prevention activities in schools and communities to aim at making children less vulnerable to 'sampling', increasing their self-efficacy expectations regarding emotional situations and making them aware of the influence of their best friend.