Determinants of Tobacco use in Zambia

Abstract

Background: The consumption of tobacco is of major public health concern globally. Its use has over the past 25 years grown in popularity in Africa too. As Zambia is a country battling with the high burden of communicable diseases such as HIV/AIDS, Malaria and Tuberculosis, the projected increase in tobacco-attributable mortality is likely to make a bad situation only worse. This study aimed to determine factors that contributed to one’s use of tobacco based on data collected in the national Demographic Health Survey of 2007. Methods: This study was a cross-sectional study that utilized data from the Zambia Demographic Health Survey (ZDHS) in order to derive estimates of prevalence and determinants of tobacco use. A total of 6494 men aged 15-59 years and 7142 women aged 15-49 years from a total of 8000 randomly surveyed households were analyzed in the tobacco survey .Cross tabulations using Chi-Square was used to establish association between tobacco use and its determinants and multivariate logistic regression established the strength of association using a p-value of ≤0.005 to determine significance. Results: Stark differences were noted in prevalence of tobacco use between men and women [23.7% (95% CI=22.7-24.8) for men and 0.8% (95% CI=0.6-1.1) for women]. Middle aged men (35-44 years) were more likely to use tobacco than those aged 15-24 years [AOR= 3.08 (95% CI= 2.35-4.04)] controlling for all other factors. While it was the elderly women who were of greater likelihood to use tobacco [AOR= 6.42 (95% CI= 1.93-21.52)] as compared to women in the age group 15-24 yrs holding all other factors constant. Lower education, being of poorer quintile and use of alcohol were some of the other factors that put one at higher risk of using tobacco. In comparison to residents of Central province and controlling for all other factors, those in Western, Luapula and Eastern provinces had higher odds of using tobacco. The influence of religion was however insignificant for both sexes. Conclusion: Tobacco use is still a public health problem in Zambia, more so in men than women. The concentration of this practice in groups with poor socioeconomic status might suggest serious limitations in past health promotion efforts. There is thus an urgent need to refocus health promotion messages to target such most affected population.