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Smoking in Nigeria: Estimates from the Global Adult Tobacco Survey (GATS) 2012

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Smoking in Nigeria: Estimates from the Global Adult Tobacco Survey (GATS) 2012 Journal of Scientific Research & Reports 11(5): 1-10, 2016; Article no.JSRR.27278 ISSN: 2320-0227 SCIENCEDOMAIN international www.sciencedomain.org Smoking in Nigeria: Estimates from the Global Adult Tobacco Survey (GATS) 2012 Folashayo Adeniji 1*, Eniola Bamgboye 2 and Corné van Walbeek 3 1Department of Health Policy and Management, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria. 2Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria. 3School of Economics, Faculty of Commerce, University of Cape Town, Cape Town, South Africa. Authors’ contributions This work was carried out in collaboration between all authors. Author FA designed the study, wrote the protocol, and wrote the first draft of the manuscript. Author FA managed the literature searches, analyses of the study was performed by authors EB and CW provided supervision and edited the manuscript. All authors read and approved the final manuscript. Article Information DOI: 10.9734/JSRR/2016/27278 Editor(s): (1) Arun Kumar Nalla, Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine, USA. (2) Luigi Rodino, Professor of Mathematical Analysis, Dipartimento di Matematica, Università di Torino, Italy. Reviewers: (1) Anonymous, University Malaya, Kuala Lumpur, Malaysia. (2) Malakeh Z. Malak, Al-Zaytoonah University of Jordan, Amman, Jordan. (3) Kenneth Nugent, Texas Tech University Health Sciences Center, USA. Complete Peer review History: http://www.sciencedomain.org/review-history/15706 Received 26 th May 2016 Accepted 2nd August 2016 Original Research Article th Published 7 August 2016 ABSTRACT Aim: Tobacco remains the leading cause of preventable deaths, causing about 6 million deaths globally every year. Despite the widely known health effects of smoking, the prevalence of tobacco use is gradually increasing in developing countries including Nigeria. This study was carried out to provide a clear understanding of the patterns, social distribution and predictors of smoking in Nigeria. Study Design: Data on tobacco use and the socio-demographic as well as smoking related characteristics of ever smoked, never smoked and current smokers were obtained from the Global Adult Tobacco Survey (GATS). Global Adult Tobacco Survey is a cross-sectional, nationally representative population based survey implemented for Nigeria in 2012. The data comprises of responses from adults of 15 years of age and above. A cross-sectional stratified multi-stage cluster _____________________________________________________________________________________________________ *Corresponding author: E-mail: [email protected]; Adeniji et al.; JSRR, 11(5): 1-10, 2016; Article no.JSRR.27278 sampling was adopted for the survey with a sample of 11,107 systematically selected households. Methodology: The analysis included generation of frequencies, proportions and means for relevant independent variables. Bivariate analysis using chi square test was done as well as multivariate logistic regression analysis after considering the clustering effect. Unadjusted odds ratios were also obtained. All statistical test were set at 5% level of significance. Results: The overall smoking prevalence was 4.4%, in which 78.1% are daily smokers. The mean age of initiation of daily smoking was 20.5±5.9years. There was a significant association between age, gender, education, occupation, religion, region, location and smoking status. (p <0.001). The odds of cigarette smoking was highest within age ranges 25-34(OR 2.68, 95% CI: 1.6-4.3) and 45- 54 (2.43, 95%CI: 1.4-4.0) respectively, relative to 15-24 year olds. Gender was found to be an independent predictor of the probability of whether an adult smokes or not as women were about 30 times less likely to smoke than men (OR 0.03; 95% CI: 0.02-0.06). Conclusion: Public health in Nigeria will benefit from measures that will aim at ensuring that the use of tobacco is kept low. More efforts should be made to prevent tobacco industry’s strategies to expand the market of their products in the country. Keywords: Cigarettes; public health; smoking; tobacco. 1. INTRODUCTION relationship between the price of cigarette and smoking among youths. Smoking remains the leading cause of preventable deaths, causing almost 6 million Accurate information on the prevalence, patterns deaths globally every year [1]. Tobacco use is and predictors of smoking in the world’s poorest responsible for over 20 percent of all cancer nations remains sparse [8]. For sub-Saharan deaths and 70 percent of all lung cancer deaths Africa, in particular, a weak knowledge base worldwide. It is also a risk factor for respiratory limits the targeting of strategies to combat the diseases (including asthma, bronchitis and potential growth of tobacco use and its harmful emphysema) and cardiovascular diseases and effect on future mortality. The strategies to stroke [2,3]. combat the globalization of tobacco should be focused on better describing the extent and social distribution of the problem [10-12]. There Despite all these, the number of smokers is evidence that suggests that tobacco use is worldwide has now risen to about 1.3 billion and increasing in developing countries [13], and so may well reach 1.5 billion by 2025 [4]. This surveillance of smoking prevalence can aid in increase in the consumption of tobacco is largely developing locally grounded actions for tobacco due to the targeting of young people and women control [1,14]. This will prevent an escalation of by transnational tobacco companies. In tobacco use in these countries and therefore response, global public health organisations aim forestall the probable public health burden of to provide consistent anti-smoking policies smoking in the incoming years. across the world [5,6]. However, to design appropriate scientifically-based policies to control In Nigeria, not much is known about the socio- the use of tobacco, there is a need to understand demographic dimensions of smoking from a the patterns and social distribution of smoking national perspective, even though there are [7]. existing studies on tobacco use among various sub-population groups. Desalu et al. [15], carried There have been numerous studies with the out a study to determine the epidemiology of objectives of providing a scientific description of tobacco smoking in the adult population of north- the social determinants of smoking. Pampel [8] eastern Nigeria using a cross-sectional survey of found that high cigarette use was in urban; less 1793 adults in Yola. The prevalence of current educated and lower economic status workers. smoking was 45.3% among males and 18.4% Decicca et al. [9] conducted a study using a females, respectively. They conclude that the measure of anti-smoking sentiment and merged prevalence of tobacco smoking was very high in it with micro-data on youth smoking in the United the study population. States in 1992 and 2000. The result showed a significant negative influence of anti-smoking Other studies have been carried out by Pampel sentiment on youth smoking and a weak [8] and John [8,16] which included Nigeria 2 Adeniji et al.; JSRR, 11(5): 1-10, 2016; Article no.JSRR.27278 among the 14 and 17 Sub-Saharan African knowledge about all members of the household countries in their respective studies. Their was selected to answer questions about the studies used the Demographic Health Survey for household it is representing. Interviews of these countries, which included some segments household representatives were completed for of the population by age (15-49 yrs for women 9765 (88%) of selected households. The GATS and 15-59 years for men). The primary reason contains information not captured in the earlier for this age-biased inclusion criterion is because Demographic Health Surveys 1 and the Global the Demographic Health Survey was primarily Youth Tobacco Survey carried out in Nigeria. designed to investigate fertility and issues related This positions the survey as the most robust data to female health. set for carrying out extensive estimates of social smoking determinants in the country. This study however, uses a nationally representative data, the Global Adult Tobacco 2.2 Data Analysis Survey conducted in 2012 to investigate the socio-demographic correlates of tobacco Secondary data analysis of the Global Adult smoking in Nigeria and aims at providing a Tobacco Survey was used to determine the baseline information for the design of tobacco social and demographic correlates of tobacco control policies especially for adults aged 15 use. The analysis included the generation of years and above and both men and women. frequencies, proportions and means for relevant independent variables. Bivariate analysis using chi square test was also done as well as 2. METHODS AND MATERIALS multivariate logistic regression analysis after considering the clustering effect. Unadjusted 2.1 Data odds ratios were also obtained. All statistical tests were set at 5% level of significance. The Global Adult Tobacco Survey is a global standard for systematically monitoring adult 3. RESULTS tobacco use. It is a population-based survey that is nationally representative. The data comprises 3.1 Smoking Characteristics of Nigerian of responses from adults of 15 years of age and Adults above with the use of a standard core questionnaire, sample design, data collection As shown in Table 1, the prevalence of smoking and management procedure, reviewed by was 4.4%
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