Patterns of Tobacco Use in Low and Middle Income Countries by Tobacco Product and Sociodemographic Characteristics: Nationally Representative Survey Data From 82 Countries Publisher Pubmed



Theilmann M¹ ; Lemp JM¹ ; Winkler V¹ ; Mannegoehler J^{2, 3} ; Marcus ME⁴ ; Probst C^{1, 5, 6} ; Lopezarboleda WA¹ ; Ebert C⁷ ; Bommer C^{1, 4} ; Mathur M⁸ ; Andallbrereton G⁹ ; Bahendeka SK¹⁰ ; Bovet P^{11, 12} ; Farzadfar F¹³ Show All Authors Show Affiliations
Source: The BMJ Published:2022

Abstract

Objectives: To determine the prevalence and frequency of using any tobacco product and each of a detailed set of tobacco products, how tobacco use and frequency of use vary across countries, world regions, and World Bank country income groups, and the socioeconomic and demographic gradients of tobacco use and frequency of use within countries. Design: Secondary analysis of nationally representative, cross-sectional, household survey data from 82 low and middle income countries collected between 1 January 2015 and 31 December 2020. Setting: Population based survey data. Participants: 1 231 068 individuals aged 15 years and older. Main outcome measures: Self-reported current smoking, current daily smoking, current smokeless tobacco use, current daily smokeless tobacco use, pack years, and current use and use frequencies of each tobacco product. Products were any type of cigarette, manufactured cigarette, hand rolled cigarette, water pipe, cigar, oral snuff, nasal snuff, chewing tobacco, and betel nut (with and without tobacco). Results: The smoking prevalence in the study sample was 16.5% (95% confidence interval 16.1% to 16.9%) and ranged from 1.1% (0.9% to 1.3%) in Ghana to 50.6% (45.2% to 56.1%) in Kiribati. The user prevalence of smokeless tobacco was 7.7% (7.5% to 8.0%) and prevalence was highest in Papua New Guinea (daily user prevalence of 65.4% (63.3% to 67.5%)). Although variation was wide between countries and by tobacco product, for many low and middle income countries, the highest prevalence and cigarette smoking frequency was reported in men, those with lower education, less household wealth, living in rural areas, and higher age. Conclusions: Both smoked and smokeless tobacco use and frequency of use vary widely across tobacco products in low and middle income countries. This study can inform the design and targeting of efforts to reduce tobacco use in low and middle income countries and serve as a benchmark for monitoring progress towards national and international goals. © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.