ReviewA systematic literature review of tobacco use among adults 15 years and older in sub-Saharan Africa
Section snippets
Background
Approximately 1 billion men and 250 million women, aged 15 years and older, in the world smoke tobacco (Action on Smoking and Health, 2004). Of these, 50% of the men and 9% of the women live in developing countries. These statistics, together with evidence of the decline in tobacco use in developed nations such as the United Kingdom, United States, Canada, Japan, Australia and New Zealand, led the authors of the World Health Organisation's Tobacco Atlas to conclude that the tobacco epidemic is
Review methodology
The review comprises articles that were published in peer-reviewed journals at any time during the last century up to mid-2005. All articles report prevalence data, patterns and initiation of tobacco use among sub-Saharan African adult populations. Following lower age limits for adults versus youth from the Tobacco Atlas (Mackay and Eriksen, 2002), studies were included in which the samples’ lower age limit was 15 years. Articles about tobacco-related medical conditions were excluded. Despite
Results and discussion
The search resulted in the retrieval of 55 articles that met the inclusion criteria. These studies were undertaken in the following sub-Saharan African countries: Benin (n = 1), Chad (n = 1), The Gambia (n = 1), Ghana (n = 1), Ivory Coast (n = 1), Kenya (n = 3), Malawi (n = 2), Nigeria (n = 10), Senegal (n = 7), South Africa (n = 24), Tanzania (n = 1), Uganda (n = 2), Zambia (n = 1) and Zimbabwe (n = 1).
Concluding comments
Despite the variation in the information and inconsistency of reporting across studies and countries, this review has revealed that males generally, and certain ethnic and/or RCSGs are at increased risk for tobacco use in SSA. Furthermore, most studies revealed initiation of tobacco use during late adolescence or early adulthood. However, there is no clear pattern regarding SES or urban/rural differences which in our view may reflect the lack of detailed research on these topics.
Given the small
Acknowledgements
The authors would like to acknowledge the assistance of Kimya McCray, Selima Taylor and Todné Thomas. The authors would also like to acknowledge the Minority International Research Training Program of the Fogarty International Center (5T37 TWOO113-04), the National Institutes of Drug Abuse (P50 DA10075), and the Fogarty International Center of the National Institutes of Health, International Tobacco and Health Research and Capacity Building Program (IROI TWO5955-02) for their research grant
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