Factors associated with cigarette smoking among learners at a high school in KwaZulu-Natal

Background: Young smokers are said to have increased risk of nicotine addiction, even at lower levels of consumption compared to adults, making smoking cessation among this group much more difficult. A survey previously conducted in South Africa indicated an early smoking debut age of below 18 years. Aim: This study investigated the prevalence of cigarette smoking and associated factors among high school learners. Setting: The study was conducted at a high school located in Madadeni township of KwaZulu-Natal. Methods: This cross-sectional study collected data through interviews using self-administered questionnaires. Data analysis was conducted on Epi Info 7 and STATA 17. Results: Eighty-four (21%) of the 400 participants reported smoking cigarettes. Of these, forty-nine (58.3%) had a smoking friend. Sixty out of 81 (74.1%) accessed cigarettes from the shops, whilst 69.2% (n = 54/78) smoked inside the school premises. Seventy-seven (92.7%) of 83 smokers expressed intention to quit smoking. Higher odds of cigarette smoking were observed among participants who were male and those who had a smoking family member, respectively, (adjusted odds ratio [AOR] = 2.33, 95% CI = 1.29–4.17) and (AOR = 5.82, 95% CI = 3.08–11.0), p = < 0.05. Conclusion: This study found 21% of high school learner participants who smoked cigarettes. Laws prohibiting smoking in schools and sale of cigarettes to minors should be reinforced. Contribution: intention to quit cigarette smoking as expressed by smoking learners calls for the establishment of school-based programme for smoking cessation.