BackgroundPanama has the lowest overall prevalence of tobacco use in the Americas, however rates are almost three times higher in the indigenous territory of Kuna Yala compared with the national average. Most people who smoke started during adolescence, making this a key period for tobacco control efforts.ObjectiveWe aimed to examine tobacco access and use among adolescents (13 to 15 years old) in Kuna Yala compared with nationwide Panama using data from the 2017 Global Youth Tobacco Survey, a standardised international tool for assessing key tobacco control indicators among adolescents.ResultsThe prevalence of current tobacco use among 13 to 15 year olds in Kuna Yala was 14.0% (95% CI: 11.6% to 16.9%)—almost twice the national average of 7.8% (95% CI: 6.3% to 9.4%). Half of all adolescents in Kuna Yala estimated the cost of a 20-cigarette pack as less than US$0.75, compared with 16.2% of adolescents across of Panama (p value <0.01).ConclusionsKuna Yala is one of the few indigenous territories in Spanish-speaking countries where key tobacco control indicators have recently been assessed. Higher tobacco use and lower reported cigarette prices in that region may be linked with the presence of barter economy which may give adolescents more ready access to cigarettes than in other parts of Panama. There is a need for more indigenous-specific data to help build the evidence base to improve tobacco control and reduce commercial tobacco use among indigenous peoples.
Background: Suicidal ideation can often lead to suicide attempts and completed suicide. Studies have shown that Sri Lanka has one of the highest rates of suicide in the world but so far no studies have looked at prevalence of suicidal ideation in a general population in Sri Lanka. Aims: We wanted to determine the prevalence of suicidal ideation by randomly selecting six Divisional Secretariats (Dss) out of 17 in one district. This district is known to have higher than national average rates of suicide. Methods: 808 participants were interviewed using Sinhala versions of GHQ-30 and Beck’s Scale for Suicidal Ideation. Of these, 387 (48%) were males, and 421 (52%) were female. Results: On Beck’s Scale for Suicidal Ideation, 29 individuals (4%) had active suicidal ideation and 23 (3%) had passive suicidal ideation. The active suicidal ideators were young, physically ill and had higher levels of helplessness and hopelessness. Conclusions: The prevalence of suicidal ideation in Sri Lanka is lower than reported from the West and yet suicide rates are higher. Further work must explore cultural and religious factors.
Tobacco use and access among 13 to 15 year olds in Kuna Yala, an indigenous region of Panama