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Open Access 01-12-2021 | Research article

Prevalence and socio-demographic correlates of tobacco and alcohol use in four sub-Saharan African countries: a cross-sectional study of middle-aged adults

Authors: Palwende Romuald Boua, Cassandra Claire Soo, Cornelius Debpuur, Innocent Maposa, Shai Nkoana, Shukri F. Mohamed, Solomon Choma, Abraham Oduro, Gershim Asiki, Lisa K. Micklesfield, Francesc Xavier Gómez-Olivé, Hermann Sorgho, Sumaya Mall, Michèle Ramsay, as members of AWI-Gen and the H3Africa Consortium

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Substance misuse is a global public health problem. In addition to social and economic concerns, consumption of tobacco and alcohol is associated with susceptibility to cardiovascular, respiratory, and infectious diseases, cancers, and risk of transition to substance use disorders. African data suggest regional differences in the prevalence and patterns of substance use, but a number of key questions remain. This cross-sectional population-based study of middle-aged adults aims to examine prevalence and socio-demographic correlates of substance use in four sub-Saharan African countries, in rural and urban settings.

Methods

Participants aged between 40 and 60 years were recruited from six research centres as part of the Africa Wits-INDEPTH partnership for Genomic Research study. Data on patterns of tobacco and alcohol consumption was captured, and the latter further assessed using the CAGE (cut-annoyed-guilty-eye) questionnaire.

Results

Data from 10,703 participants suggested that more men (68.4%) than women (33.3%) were current substance users. The prevalence of current smoking was significantly higher in men than in women (34.5% vs 2.1%, p < 0.001). Smokeless tobacco was used more by women than men (14.4% vs 5.3%, p < 0.001). Current smoking was associated with alcohol consumption in men, and smoking cessation in men was associated with being a former drinker, having higher socio-economic status, and if married or cohabiting. Current alcohol consumption was higher in men, compared to women (60.3% vs 29.3%), and highest in men from Soweto (70.8%) and women from Nanoro (59.8%). The overall prevalence of problematic alcohol consumption among men was 18.9%, and women 7.3%. Men were significantly more likely to develop problematic drinking patterns, and this was more common in those who were divorced or widowed, and in current smokers.

Conclusions

Regional variation in the patterns and prevalence of substance use was observed across study sites, and in rural and urban settings. The high levels of substance use recorded in this study are of concern due to the increased risk of associated morbidities. Further longitudinal data will be valuable in determining trends in substance misuse in Africa.

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Peacock A, Leung J, Larney S, Colledge S, Hickman M, Rehm J, et al. Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction. 2018;113(10):1905–26. https://doi.org/10.1111/add.14234.CrossRefPubMed

Reitsma MB, Fullman N, Ng M, Salama JS, Abajobir A, Abate KH, et al. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the global burden of disease study 2015. Lancet. 2017;389(10082):1885–906. https://doi.org/10.1016/S0140-6736(17)30819-X.CrossRef

Mdege ND, Shah S, Ayo-Yusuf OA, Hakim J, Siddiqi K. Tobacco use among people living with HIV: analysis of data from demographic and health surveys from 28 low-income and middle-income countries. Lancet Glob Heal. 2017;5(6):e578–92. https://doi.org/10.1016/S2214-109X(17)30170-5.CrossRef

Degenhardt L, Charlson F, Ferrari A, Santomauro D, Erskine H, Mantilla-Herrara A, et al. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry. 2018;5(12):987-1012. https://doi.org/10.1016/S2215-0366(18)30337-7. Epub 2018 Nov 1.

Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet. 2012;380(9859):2224–60. https://doi.org/10.1016/S0140-6736(12)61766-8.CrossRefPubMedPubMedCentral

Sreeramareddy CT, Pradhan PM, Sin S. Prevalence , distribution , and social determinants of tobacco use in 30 sub-Saharan African countries; 2014. p. 1–13.

Andersson LMC, Twum-Antwi A, Staland-Nyman C, van Rooyen DRM. Prevalence and socioeconomic characteristics of alcohol disorders among men and women in the eastern Cape Province, South Africa. Heal Soc Care Commun. 2018;26(1):e143–53. https://doi.org/10.1111/hsc.12487.CrossRef

Magidson JF, Dietrich J, Otwombe KN, Sikkema KJ, Katz IT, Gray GE. Psychosocial correlates of alcohol and other substance use among low-income adolescents in peri-urban Johannesburg, South Africa: a focus on gender differences. J Health Psychol. 2017;22(11):1415–25. https://doi.org/10.1177/1359105316628739.CrossRefPubMed

Gedif T, Azale T, Nigusie A. Substance use and associated factors among Gumuz people in Benishangul-Gumuz regional state, Mandura woreda, Northwest Ethiopia. Subst Abus Treat Prev Policy. 2019;14(1):36. https://doi.org/10.1186/s13011-019-0225-2.

10.

Takahashi R, Wilunda C, Magutah K, Mwaura-Tenambergen W, Wilunda B, Perngparn U. Correlates of alcohol consumption in rural western Kenya: a cross-sectional study. BMC Psychiatry. 2017;17(1):175. https://doi.org/10.1186/s12888-017-1344-9.

11.

Gebremariam TB, Mruts KB, Neway TK. Substance use and associated factors among Debre Berhan University students, Central Ethiopia. Subst Abus Treat Prev Policy. 2018;13(1):13. https://doi.org/10.1186/s13011-018-0150-9.

12.

Peltzer K, Phaswana-Mafuya N. Drug use among youth and adults in a population-based survey in South Africa. South Afr J Psychiatry. 2018;24:1139. https://doi.org/10.4102/sajpsychiatry.v24i0.1139. eCollection 2018.

13.

Peltzer K, Chao LW, Ramlagan S, Szrek H. Daily tobacco use and problem drinking among urban adults in South Africa: a longitudinal study. Pan Afr Med J. 2019;1:32.

14.

Kuteesa MO, Seeley J, Cook S, Webb EL. Multi-level experiences and determinants of alcohol misuse and illicit drug use among occupational groups at high-risk of HIV in sub-Saharan Africa: a thematic synthesis of qualitative findings. Glob Public Health. 2020;15(5):715-33. https://doi.org/10.1080/17441692.2019.1679216. Epub 2019 Oct 23.

15.

Molla Z, Dube L, Krahl W, Soboka M. Tobacco dependence among people with mental illness: a facility-based cross sectional study from Southwest Ethiopia. BMC Res Notes. 2017;10(1):289. https://doi.org/10.1186/s13104-017-2608-7.

16.

Jenkins R, Othieno C, Ongeri L, Kiima D, Sifuna P, Kingora J, et al. Alcohol consumption and hazardous drinking in western Kenya — a household survey in a health and demographic surveillance site; 2015. p. 1–10.

17.

Nkoana S, Sodi T, Darikwa TB. Heavy episodic alcohol drinking among students from a rural south African university: correlates with personal-social variables. J Psychol Africa. 2016;26(4):368–72. https://doi.org/10.1080/14330237.2016.1208949.CrossRef

18.

National Department of Health (NDoH), South African Medical Research Council (SAMRC) and I. South Africa Demographic and Health Survery 2016. 2019.

19.

Kassa A, Wakgari N, Taddesse F. Determinants of alcohol use and khat chewing among Hawassa university students, Ethiopia: a cross sectional study. Afr Health Sci. 2016;16(3):822–30. https://doi.org/10.4314/ahs.v16i3.24.CrossRefPubMedPubMedCentral

20.

Ayano G, Assefa D, Haile K, Chaka A, Solomon H, Hagos P, et al. Mental, neurologic, and substance use (MNS) disorders among street homeless people in Ethiopia. Ann General Psychiatry. 2017;16:40. https://doi.org/10.1186/s12991-017-0163-1. eCollection 2017.

21.

Elf JL, Variava E, Chon S, Lebina L, Motlhaoleng K, Gupte N, et al. Prevalence and correlates of smoking among people living with HIV in South Africa. Nicotine Tob Res. 2018;20(9):1124–31. https://doi.org/10.1093/ntr/ntx145.CrossRefPubMed

22.

Kagee A, Saal W, Bantjes J. The relationship between symptoms of common mental disorders and drug and alcohol misuse among persons seeking an HIV test. AIDS Care Psychol Socio-Medical Asp AIDS/HIV. 2018;30(2):219–23. https://doi.org/10.1080/09540121.2017.1361510.CrossRef

23.

Oppong AK. Cannabis and amphetamine use and its psychosocial correlates among school-going adolescents in Ghana. Child Adolesc Psychiatry Ment Health. 2019;29:13(1).

24.

Riva K, Allen-Taylor L, Schupmann WD, Mphele S, Moshashane N, Lowenthal ED. Prevalence and predictors of alcohol and drug use among secondary school students in Botswana: a cross-sectional study. BMC Public Health. 2018;18(1):1396.https://doi.org/10.1186/s12889-018-6263-2.

25.

Jallow IK, Britton J, Langley T. Prevalence and determinants of susceptibility to tobacco smoking among students in the Gambia. Nicotine Tob Res. 2019;21(8):1113–21. https://doi.org/10.1093/ntr/nty128.CrossRefPubMed

26.

Wesonga R, Guwatudde D, Bahendeka SK, Mutungi G, Nabugoomu F, Muwonge J. Burden of cumulative risk factors associated with non-communicable diseases among adults in Uganda: evidence from a national baseline survey. Vol. 15. London: International Journal for Equity in Health; 2016.

27.

Ramsay M, Crowther N, Tambo E, Agongo G, Baloyi V, Dikotope S, et al. H3Africa AWI-gen collaborative Centre: a resource to study the interplay between genomic and environmental risk factors for cardiometabolic diseases in four sub-Saharan African countries. Glob Heal Epidemiol Genomics. 2016;1:e20. https://doi.org/10.1017/gheg.2016.17. eCollection 2016.

28.

Ali SA, Soo C, Agongo G, Alberts M, Amenga-Etego L, Boua RP, et al. Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for phase 1 of the AWI-gen population cross-sectional study. Glob Health Action. 2018;11(sup2):1507133. https://doi.org/10.1080/16549716.2018.1507133.CrossRefPubMedPubMedCentral

29.

Richter L, Norris S, Pettifor J, Yach D, Cameron N. Cohort profile: Mandela’s children: The 1990 birth to twenty study in South Africa. Int J Epidemiol. 2007;36(3):504–11. https://doi.org/10.1093/ije/dym016.CrossRefPubMed

30.

Kahn K, Collinson MA, Xavier Gómez-olivé F, Mokoena O, Twine R, Mee P, et al. Profile: Agincourt health and socio-demographic surveillance system. Int J Epidemiol. 2012;41(4):988–1001. https://doi.org/10.1093/ije/dys115.CrossRefPubMedPubMedCentral

31.

Kanjala C, Alberts M, Byass P, Burger S. Spatial and temporal clustering of mortality in Digkale HDSS in rural northern South Africa. Glob Health Action. 2010;3. https://doi.org/10.3402/gha.v3i0.5236.

32.

Beguy D, Elung’ata P, Mberu B, Oduor C, Wamukoya M, Nganyi B, et al. Health & demographic surveillance system profile: The Nairobi urban health and demographic surveillance system (NUHDSS). Int J Epidemiol. 2015;44(2):462–71. https://doi.org/10.1093/ije/dyu251.CrossRefPubMed

33.

Oduro AR, Wak G, Azongo D, Debpuur C, Wontuo P, Kondayire F, et al. Profile of the Navrongo health and demographic surveillance system. Int J Epidemiol. 2012;41(4):968–76. https://doi.org/10.1093/ije/dys111.CrossRefPubMed

34.

Derra K, Rouamba E, Kazienga A, Ouedraogo S, Tahita MC, Sorgho H, et al. Profile: Nanoro health and demographic surveillance system. Int J Epidemiol. 2012;41(5):1293–301. https://doi.org/10.1093/ije/dys159.CrossRefPubMed

35.

Ewing JA. Detecting Alcoholism: The CAGE Questionnaire. JAMA. 1984;252(14):1905–7. https://doi.org/10.1001/jama.1984.03350140051025.CrossRefPubMed

36.

Ministere De La Sante Burkina Faso. Rapport de l’enquête STEPS; 2013. p. 1973.

37.

Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006;21(6):459–68. https://doi.org/10.1093/heapol/czl029.CrossRefPubMed

38.

Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377–81. https://doi.org/10.1016/j.jbi.2008.08.010.CrossRefPubMed

39.

Pedro JM, Brito M, Barros H. Tobacco consumption and nicotine dependence in Bengo Province, Angola: A community-based survey. PLoS One. 2017;12(11):e0188586. https://doi.org/10.1371/journal.pone.0188586. eCollection 2017.

40.

Ferreira-Borges C, Parry CDH, Babor TF. Harmful Use of Alcohol: A Shadow over Sub-Saharan Africa in Need of Workable Solutions. Int J Environ Res Public Health. 2017;14(4):346. https://doi.org/10.3390/ijerph14040346.

41.

Ward CL, Mertens JR, Flisher AJ, Bresick GF, Sterling SA, Little F, et al. Prevalence and correlates of substance use among south African primary care clinic patients. Subst Use Misuse. 2008;43(10):1395–410. https://doi.org/10.1080/10826080801922744.CrossRefPubMedPubMedCentral

42.

Ndinda C, Ndhlovu TP, Juma P, Asiki G, Kyobutungi C. The evolution of non-communicable diseases policies in post-apartheid South Africa. BMC Public Health. 2018;18(Suppl 1):956. https://doi.org/10.1186/s12889-018-5832-8.

43.

Drope J, Schluger NW, Cahn Z, Drope J, Hamill S, Islami F, et al. The tobacco atlas. Choice Rev Online. 2018;50(05):50–2422 50–2422.

Title: Prevalence and socio-demographic correlates of tobacco and alcohol use in four sub-Saharan African countries: a cross-sectional study of middle-aged adults
Authors: Palwende Romuald Boua
Cassandra Claire Soo
Cornelius Debpuur
Innocent Maposa
Shai Nkoana
Shukri F. Mohamed
Solomon Choma
Abraham Oduro
Gershim Asiki
Lisa K. Micklesfield
Francesc Xavier Gómez-Olivé
Hermann Sorgho
Sumaya Mall
Michèle Ramsay
as members of AWI-Gen and the H3Africa Consortium
Publication date: 01-12-2021
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-11084-1

2024 ASCO Annual Meeting

Springer Medicine

Prevalence and socio-demographic correlates of tobacco and alcohol use in four sub-Saharan African countries: a cross-sectional study of middle-aged adults

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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