Cigarette smoking and reasons for leaving school among school dropouts in South Africa

Background: School dropouts are those between 13-20 years old, have not completed their schooling and are not currently enrolled in school. School dropouts are at heightened risk of tobacco use and developing tobacco related disease and disability compared to in-school learners. The aim of this paper was to examine the relationship between reasons for leaving school and past month cigarette smoking, taking into account possible gender differences. Methods: Multiple logistic regression with gender as an effect moderator was used to analyse survey data from 4185 school dropouts. Province and area (urban, rural and peri - urban) were later incorporated into the analysis as possible effect moderators. Results: Past month cigarette smoking was reported by 50.4% of the respondents with boys (61.6%) smoking considerably more compared to girls (33.9%). We did not find any significant association between the reasons for leaving school and tobacco smoking when gender was tested as an effect moderator. However, dropping out of school for 'not being able to pay school fees', was found to be associated with less cigarette smoking, but only among girls residing in urban areas. Conclusions: Given the high prevalence of tobacco smoking among school dropouts, more research is needed to further explore the relationship between tobacco smoking and reasons for leaving school that were not considered in this study.