{ "abstract": "Tobacco use often begins during adolescence, increasing the risk of lifelong nicotine dependence and future non-communicable diseases. In sub-Saharan Africa, concerns are rising due to aggressive tobacco industry marketing and expanding nicotine product markets, yet nationally representative data covering both in-school and out-of-school adolescents remain limited. Understanding tobacco use patterns during early and mid-adolescence, a critical period for experimentation and initiation, is essential for informing prevention strategies. We conducted nationally representative cross-sectional household surveys between March and June 2024 using harmonized tools and multistage stratified cluster sampling in Democratic Republic of Congo (DRC), Nigeria and Kenya. Adolescents aged 10–17 years completed standardized face-to-face interviews with response rates of 96% in DRC, 94% in Nigeria and 96% in Kenya. The outcomes were current use of any tobacco, smoked tobacco and smokeless tobacco. Current tobacco use was defined as self-reported use in the past 30 days of any tobacco product including cigarettes, cigars, shisha/waterpipe and smokeless-tobacco (snuff/chewing). Analyses incorporated sampling weights to estimate prevalence, assessed subgroup differences using Rao-Scott chi-square tests, and multivariable logistic regression models were fitted separately for each country and outcome. Among 18,612 adolescents (4,675 in DRC, 7,502 in Nigeria, 6,435 in Kenya), 6·5% (95% CI: 4·9–8·6) reported current tobacco use, with variations across countries (11·9% in DRC, 3·6% in Nigeria, and 2·5% in Kenya). Similar patterns were observed for smoked and smokeless tobacco use. Tobacco use was higher among boys, older adolescents, and those engaged in work. In adjusted analyses, being a boy and older was associated with higher odds of use. Being enrolled in school was linked to lower odds of use in DRC and Kenya, while having both parents alive reduced odds of use in DRC and Nigeria. Higher parental education was associated with lower odds of tobacco use in Kenya but higher odds of use in DRC and Nigeria. Overall, adolescents’ tobacco use remains a critical public health challenge and observed cross-country differences highlight the need for tailored, context-specific interventions and strengthened tobacco control efforts.", "abstract_shown": true, "affiliations": [ "Data Synergy and Evaluation Unit, African Population and Health Research Center, Manga Close, Nairobi, Kenya", "Department of Statistics and Actuarial Science, University of Ghana, Accra, Ghana", "University of York, Heslington, York, United Kingdom", "Centre for Research in Health and Development, York, United Kingdom", "Chronic Disease Management Unit, African Population and Health Research Center, Manga Close, Nairobi, Kenya", "Development Gateway: An IREX Venture, Washington, District of Columbia, United States of America", "Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Canada", "Ottawa Model for Smoking Cessation, University of Ottawa Heart Institute, Ottawa, Canada", "APIN Public Health Initiatives, Plot 1551, Zone E, Apo Resettlement, FCT, Abuja, Nigeria", "Research Initiatives for Social Development, Bukavu, Democratic Republic of the Congo", "Research Unit on the Economics of Excisable Products (REEP), School of Economics, University of Cape Town, Cape Town, South Africa", "Research and Communications Services Ltd (RCS), Lagos, Nigeria" ], "article_type": "Research Article", "arxiv": null, "author_total": 19, "authors": [ { "affs": [ 0 ], "name": "Grace Kyule" }, { "affs": [ 1 ], "name": "Samuel Iddi" }, { "affs": [ 2 ], "name": "Noreen Dadirai Mdege" }, { "affs": [ 3 ], "name": "Lyagamula Kisia" }, { "affs": [ 4 ], "name": "Terefe Gelibo Argefa" }, { "affs": [ 5 ], "name": "Olatunbosun Abolarin" }, { "affs": [ 6 ], "name": "Didier M. Mirindi" }, { "affs": [ 7 ], "name": "Retselisitsoe Pokothoane" }, { "affs": [ 8 ], "name": "Boscow Okumu" }, { "affs": [ 9 ], "name": "Nelson Mbaya" }, { "affs": [ 10 ], "name": "Franklin Koech" }, { "affs": [ 11 ], "name": "James Kavai" }, { "name": "Akinsewa Akiode" }, { "name": "Thompson Ademola" }, { "name": "Uche Okezie" }, { "name": "Fakorede J.I" }, { "name": "Christelle Tchoupé" }, { "name": "Damazo T. Kadengye" }, { "name": "Shukri F. Mohamed" } ], "bibtex": "https://research.draconitic.com/paper/bbc1xynpgj9mj.bib", "cited_by": 0, "doi": "10.1371/journal.pone.0356891", "fulltext_url": null, "id": "bbc1xynpgj9mj", "issns": [ "1932-6203" ], "landing_url": "https://doi.org/10.1371/journal.pone.0356891", "language": null, "licence": "CC-BY-4.0", "licence_label": "CC BY 4.0", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2737|Smoking Behavior and Cessation" ], [ "plos", "/Biology and life sciences/Agriculture/Agronomy/Plant products/Tobacco" ], [ "plos", "/Biology and life sciences/Agriculture/Crop science/Plant products/Tobacco" ], [ "plos", "/Medicine and health sciences/Medical conditions/Respiratory disorders/Smoking related disorders" ], [ "plos", "/Medicine and health sciences/Mental health and psychiatry/Substance-related disorders/Smoking related disorders" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Substance-related disorders/Smoking related disorders" ], [ "plos", "/Medicine and health sciences/Public and occupational health/Tobacco control" ], [ "plos", "/Medicine and health sciences/Pulmonology/Respiratory disorders/Smoking related disorders" ], [ "plos", "/People and places/Geographical locations/Africa/Kenya" ], [ "plos", "/People and places/Geographical locations/Africa/Nigeria" ], [ "plos", "/People and places/Population groupings/Age groups/Children/Adolescents" ], [ "plos", "/People and places/Population groupings/Families/Children/Adolescents" ], [ "plos", "/Social sciences/Economics/Labor economics/Employment" ], [ "plos", "/Social sciences/Sociology/Education/Schools" ] ], "openalex": "W7203590774", "pdf_url": "https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0356891&type=printable", "pmcid": null, "pmid": null, "published": "2026-08-31", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/bbc1xynpgj9mj.ris", "sources": [ { "first_seen": "2026-10-30T12:18:02Z", "native_id": "10.1371/journal.pone.0356891", "source": "plos", "url": "https://doi.org/10.1371/journal.pone.0356891" } ], "subjects": [ { "field": "medicine", "origin": "plos:public and occupational health", "subfield": "epidemiology-public-health" }, { "field": "medicine", "origin": "plos:mental health and psychiatry", "subfield": "psychiatry" } ], "title": "Prevalence and associated factors of adolescent tobacco use in three Sub-Saharan African countries: A comparative analysis of national cross-sectional surveys", "title_text": "Prevalence and associated factors of adolescent tobacco use in three Sub-Saharan African countries: A comparative analysis of national cross-sectional surveys", "type": "peer-reviewed", "updated_at": "2026-10-30T12:18:02Z", "url": "https://research.draconitic.com/paper/bbc1xynpgj9mj", "venue": "PLOS One", "versions": [] }