Hardening determinants among adult daily smokers in nine African countries: data from the Global Adult Tobacco Survey
File(s)
Published version
Author(s)
Sreeramareddy, Chandrashekhar T
Fernandez, Esteve
Feliu, Ariadna
Type
Journal Article
Abstract
Little has been reported about hardening nor softening indicators in Africa where smoking prevalence is low. We aimed to examine the determinants of hardening in nine African countries. We conducted two separate analyses using data from the most recent Global Adult Tobacco Survey in Botswana, Cameroon, Egypt, Ethiopia, Kenya, Nigeria, Senegal, Tanzania, and Uganda (total sample of 72,813 respondents): 1) multilevel logistic regression analysis to assess individual and country-level factors associated with hardcore, high dependence, and light smoking.; 2) a Spearman-rank correlation analysis to describe the association between daily smoking and hardcore, high dependence, and light smoking at an ecological level. Age-standardized daily smoking prevalence varied from 37.3% (95 %CI: 34.4, 40.3) (Egypt) to 6.1% (95 %CI: 3.5, 6.3) (Nigeria) among men; and 2.3% (95 %CI: 0.7, 3.9) (Botswana) to 0.3% (95 %CI: 0.2, 0.7) (Senegal) among women. The proportion of hardcore and high-dependence smokers was higher among men whereas for light smokers the proportion was higher among women. At the individual level, higher age and lower education groups had higher odds of being hardcore smokers and having high dependence. Smoke-free home policies showed decreased odds of both being hardcore and highly dependent smokers daily smoking correlated weakly and negatively with hardcore smoking (r = −0.243, 95 %CI: −0.781, 0.502) among men and negatively with high dependence (r = −0.546, 95 %CI: −0.888, 0.185) and positively with light smokers (r = 0.252, 95 %CI: −0.495, 0.785) among women. Hardening determinants varied between the countries in the African region. Wide sex differentials and social inequalities in heavy smoking do exist and should be tackled.
Date Issued
2023-08-01
Date Acceptance
2023-05-02
Citation
Preventive Medicine Reports, 2023, 34
ISSN
2211-3355
Publisher
Elsevier
Journal / Book Title
Preventive Medicine Reports
Volume
34
Copyright Statement
© 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/37228834
PII: S2211-3355(23)00117-1
Subjects
Africa
CIGARETTE
Ecological analysis
FAGERSTROM TEST
GATS
HARDCORE SMOKERS
Hardening hypothesis
HYPOTHESIS
Life Sciences & Biomedicine
Multilevel analysis
NICOTINE DEPENDENCE
Public, Environmental & Occupational Health
Science & Technology
Smokers
SMOKING PREVALENCE
Softening
Publication Status
Published
Coverage Spatial
United States
Article Number
102226
Date Publish Online
2023-05-05