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Background The tobacco industry has targeted low and middle-income countries and vulnerable groups such as women and young people. In Mexico we observe a slow decrease in tobacco consumption among adults, while in adolescents the trend in tobacco use shows an increase. Previous research in Mexico do not measure determinants at neighborhood level. The aim of the study is evaluate whether the contextual and individual factors are associated with tobacco use among Mexican adolescents. Methods Data from this study came from NAS 2011 and National Census 2010. Descriptive statistics were estimated after adjusting for sampling weights. The study had two levels: individual (adolescents between 12-17 years) and contextual (neighborhoods). Multilevel logistic regression stratified by sex was conducted. Results The final sample includes 2785 adolescents from 364 neighborhoods. Prevalence of 30 days smoking in women adolescents was 3.8% and in male adolescents was 10.3%. Female adolescents exposed to second hand smoke at home were more likely to be a current smoker (OR 2.87 CI: 1.37,6.04) and in those who have an employment (OR 4.35 CI: 1.03,18.3). School attendance was inversely associated with tobacco use (OR 0.38 CI: 0.16,0.89). In Male adolescents the likelihood of being a current smoker increase according to age (OR 4.35 CI: 1.51,12.4 for 15-17 vs 12-14) and in those exposed to second hand smoke at home (OR 5.03 CI 2.38,10.6), while school attendance decrease the likelihood of being a current smoker (OR 0.14 CI: 0.05,0.39). Conclusions This study suggest that school attendance is a protective factor for smoking. Second hand smoke at home is an important factor of tobacco use. Have an employment increase the likelihood of being a current smoker only in female adolescents. Implement a successful tobacco control policy in Mexico needs to take into account educational, economics, social and gender determinants.

Background Mexico joined the Framework Convention on Tobacco Control in 2005 and introduced the general law of tobacco control in 2008. Monitoring tobacco consumption, addressing sex and age in relation to social context, is important to plan tobacco control strategies. This study was aimed at assessing social determinants of smoking in Mexico using data from GATS 2009 and 2015. Methods Data from GATS Mexico 2009 and 2015 was used to perform a secondary analysis. Weighted descriptive statistics and stratified multivariate logistic regression models were executed. Results 13,617 people in 2009 and 14,664 in 2015 were interviewed. Prevalence of current smoking was higher among men than in women (24.8% vs 7.8% in 2009 and 25.2% vs 8.2% in 2015). In 2015, women living in urban areas were more likely to be current smokers (OR: 3.1; CI: 1.5,6.8 in young and OR: 4.9; CI: 3.3,7.2 in adult women). In young women , higher odds of being current smoker were found in those exposed to secondhand smoke at home (OR: 3.5; CI: 1.9,6.4). Adult women with high socioeconomic status were more likely to be current smokers (OR: 2.5; CI: 1.2,5.0). Among young men , likelihood of being a current smoker increased with age (OR: 5.5; CI: 3.1,9.9 for 21-24 group, reference group 15-17) and in those exposed to second hand smoke at home (OR: 1.6; CI: 1.0,2.6). In adult men , likelihood of being a current smoker decreased with age (OR: 0.3, CI: 0.2,0.5 age ≥65 reference group 25-34) and in those with high education level (OR: 0.5; CI: 0.3,0.8) while living in urban areas increases the likelihood (OR: 1.6; CI: 1.3,1.9). The results were similar for 2009. Conclusions Being young and living in urban areas remain important determinants of tobacco use in Mexico. Other factors vary according to sex and age, and these should be considered for control policies.