Adult tobacco use practice and its correlates in eastern Ethiopia: a cross-sectional study

Prevalence of tobacco smoking and associated factors among adults in Ethiopia: a systematic review and meta-analysis

Introduction

The public health concern of tobacco smoking is more prevalent in low- and middle-income countries including Ethiopia. Various studies have investigated tobacco smoking in various parts of Ethiopia. However, the findings have been inconsistent and characterized by significant variability. Besides, there is no nationally representative data on the subject, which could deter the design of effective intervention strategies to reduce tobacco-related problems. Therefore, this study aimed to estimate the pooled prevalence of tobacco smoking and associated factors among adults in Ethiopia.

Methods

The study was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Guideline. A detailed search was conducted from international databases including PubMed, Cochrane Library, Science Direct, CINAHL, African Journals Online, HINARI, Global Health, and Google Scholar. The extracted data was analyzed using STATA 14 software. A random-effects model was used to estimate the effect size. The Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity among the reviewed articles, respectively.

Results

A total of 32 studies with 69,897 study participants were included in this systematic review and meta-analysis. The pooled prevalence of lifetime tobacco smoking among adults in Ethiopia was 16.0% (95% confidence Interval (CI): 13.6-18.39) and there was significant heterogeneity among the included studies (I2 = 99.1%, p < 0.001). Male adults were three times more likely to smoke tobacco as compared with females [OR = 3.22 (95% CI: 2.06-5.03)]. Being an alcohol user [OR = 3.78 (95%CI: 1.27-11.24)] and having tobacco-smoking friends [OR = 7.21 (95%CI: 5.56-9.35)] are potential determinant factors for tobacco smoking.

Conclusion

The pooled prevalence of lifetime and current tobacco smoking among adults in Ethiopia was high, which calls for urgent intervention. Therefore, prioritization of tobacco control strategies, such as creating awareness about the public health importance of tobacco smoking, can help prevent and mitigate the effects of tobacco smoking. Alcohol control law enforcement should also be strengthened.

Patterns of Non-Communicable Disease, Multimorbidity, and Population Awareness in Bahir Dar, Northwest Ethiopia: A Cross-Sectional Study

Objective

Ethiopia, like other developing countries, is going through an epidemiological transition, and high rates of non-communicable diseases (NCDs) are having a significant impact on the health system; however, there is limited evidence about community level NCD prevalence, multimorbidity, and population awareness that could inform targeted interventions and policy responses. This study aimed to identify factors associated with NCD prevalence, multimorbidity, and population awareness of NCDs in Bahir Dar, Northwest Ethiopia.

Methods

A community-based cross-sectional survey was conducted with 417 randomly sampled adults. We performed descriptive and logistic regression analyses to evaluate associations between NCD prevalence (cardiovascular diseases, diabetes, cancer, chronic respiratory diseases, chronic kidney disease, and hypertension) multimorbidity (2 or more NCDs) and demographic, socioeconomic, individual risk factors, anthropometrics, knowledge, and attitude.

Results

This study reveals that 24% of participating adults have an NCD, and 8% have multimorbidity. One-third (34.5%) have some NCD knowledge, and 75% consider NCDs more dangerous than communicable diseases. We find low NCD prevalence in participants: younger than 40 years of age (AOR 0.17, 95% CI 0.07 to 0.39); with normal body mass index (AOR 0.27, 0.10 to 0.77) and; with a family history of NCD (AOR 7.7, 4.2 to 14.1). Multimorbidity is lower in young adults (AOR 0.08, 0.03 to 0.26). NCD knowledge is higher in men (AOR 1.76, 1.06 to 2.93) and employed adults (AOR 2.91, 1.52 to 5.57), and NCD attitude in normal-weight adults (AOR 3.23, 1.42 to 7.39).

Conclusion

This study reveals a high prevalence of NCD and overall low NCD awareness in the population. Age above 40 years, family history of NCD, and weight in the obese category are significant predictors of NCD prevalence. These findings can help health professionals, health offices, and concerned stakeholders to plan targeted health interventions to reduce NCDs in the population.

Current alcohol, tobacco, and khat use and associated factors among adults living in Harari regional state, eastern Ethiopia: A community-based cross-sectional study

Background

Psychoactive substance use becomes a major public health and socioeconomic problem worldwide. Despite its burden and consequences, there is no community-based study conducted on psychoactive substance use and associated factors in eastern Ethiopia. Therefore, this study aimed to assess the magnitude and determinants of current alcohol, tobacco, and khat among adults living in Harari regional state, eastern Ethiopia.

Methods

A community-based cross-sectional study was conducted on 955 adults living in Harari regional state. Participants were randomly recruited using a simple random sampling technique. Data were collected by interviewer-administered structured and semi-structured questionnaires. Data were entered into Epi Data version 3.1 and exported to Stata version 14.0 for analysis. Logistic regression analysis was performed to determine the association between the outcome and independent variables, and the statistical significance was declared at a p < 0.5.

Results

Of 955 eligible participants, 95.29% participated in the study. The overall prevalence of current alcohol use, tobacco use, and khat use in this study was 8.24, 14.5, and 63.30%, respectively. The availability of alcohol, being unemployed, and being a current khat user were significantly associated with current alcohol use. Being male, having a low level of education, having peer pressure, having a common mental disorder, being a current alcohol user, and being a khat user were identified as significant predictors for current tobacco use. The age between 31 and 40 years, being a Muslim religion follower, being a farmer, being a current tobacco user, and availability of khat were significantly associated with current khat use.

Conclusion and recommendations

The prevalence of psychoactive substance use in the study area was relatively high compared with that of previous studies. By considering these determinants, screening, early identification, and developing appropriate intervention strategies to prevent and tackle current alcohol, tobacco, and khat use in the community should be of great concern.

[Prevalence and factors associated with smoking among adults living in the Moungali district of Brazzaville in 2021]

Introduction

tobacco epidemic is a real public health problem in the world and in Africa. The purpose of this study was to estimate the prevalence and identify factors associated with smoking among adults living in the Moungali district.

Methods

we conducted a cross-sectional analytical study of 800 adults. Two-stage random sampling was used to select subjects in the Moungali district, Brazzaville, in September 2021. Binary logistic regression using the ascending stepwise method allowed identification of the associated factors. The adjustment of the model was verified by the Hosmer Lomeshow test. Data were collected via the Kobo collect V1.30.1 app. and analyzed with the Stata 15.0 software.

Results

smoking prevalence was 4.63%, 95% CI [3.37-6.31]. Males (AOR=8.36 95% CI [3.74-18.72], p-value < 0.0001), alcohol consumption (AOR=2.6 95% CI [1.11-6.11], p-value = 0.028), and professional activity (formal or informal sector) (AOR=3.91 95% CI [1.16-13.11], p-value = 0.027) were factors significantly associated with smoking.

Conclusion

this study highlights that smoking is a stronger risk factor in men than in women. In addition, alcohol consumption and professional activity in the formal or informal sector are also factors associated with active smoking. Preventive actions focusing on these factors are necessary to effectively fight smoking in adults.

Second-Hand Tobacco Smoke Exposure and Smoke-Free Environments in Ethiopia: A Scoping Review and Narrative Synthesis

Ethiopia passed a law prohibiting tobacco smoking in all public places in 2019. We conducted a scoping review to identify gaps in the existing literature on second-hand smoke (SHS) exposure and smoke-free environments in Ethiopia that need to be prioritised for future research to support policy and practice. We conducted systematic searches in January 2022 in the following databases: Medline, EMBASE, and PsycInfo. Two reviewers independently screened the identified study reports for eligibility and extracted data from the eligible studies. The extracted data was descriptively analysed, and research recommendations were drawn. A stakeholder consultation workshop was held to identify research topics on SHS exposure and smoke-free environments in Ethiopia that they perceived to be priorities for primary research. Of the 388 research reports identified, only nine were included in the scoping review. The topics explored includes prevalence of SHS exposure (six studies); knowledge on SHS exposure (three studies); compliance to smoke-free environments legislation (two studies); and exposure to anti-smoking messages (one study). The stakeholders prioritised further research addressing compliance monitoring and enforcement of the smoke free laws in Ethiopia. There is a need for studies that test new methods for compliance monitoring and enforcement, evaluate strategies to increase knowledge on the harms of SHS exposure and the smoke-free legislation, and evaluate the current smoke-free legislation in Ethiopia.

The Magnitude of NCD Risk Factors in Ethiopia: Meta-Analysis and Systematic Review of Evidence

Background: Non-communicable Diseases (NCDs) and their risk factors are the leading contributors to morbidity and mortality globally, particularly in low- and middle-income countries including Ethiopia. To date, there has been no synthesis of the literature on the relative prevalence of NCD risk factors in Ethiopia. Methodology: We conducted a systematic review and meta-analysis of primary studies reporting on the prevalence of NCD risk factors in Ethiopia published in English from 2012 to July 2020. Pre-tested NCD search terms were applied to Medline, Embase, Scopus, CINAHL, and Global Health. Three reviewers screened and appraised the quality of the identified papers. Data extraction was conducted using a pilot tested proforma. Meta-analysis was conducted using Stata 16 and pooled prevalence estimated with associated 95% confidence intervals. Clinically heterogeneous studies that did not fulfil the eligibility criteria for meta-analysis were narratively synthesised. I² was used to assess statistical heterogeneity. Results: 47 studies fulfilled the inclusion criteria and contributed 68 NCD risk factor prevalence estimates. Hypertension was the most frequently examined NCD risk factor, with a pooled prevalence of 21% (n = 27 studies). The pooled prevalence percentages for overweight and obesity were 19.2% and 10.3%, respectively (n = 7 studies each), with a combined prevalence of 26.8% (n = 1 study). It was not possible to pool the prevalence of alcohol consumption, smoking, metabolic disorders, or fruit consumption because of heterogeneity across studies. The prevalence of alcohol use, as reported from the included individual studies, ranged from 12.4% to 13.5% (n = 7 studies). More than 90% of participants met the WHO-recommended level of physical activity (n = 5 studies). The prevalence of smoking was highly variable, ranging between 0.8% and 38.6%, as was the prevalence of heavy alcohol drinking (12.4% to 21.1%, n = 6 studies) and metabolic syndrome (4.8% to 9.6%, n = 5 studies). Fruit consumption ranged from 1.5% up to the recommended level, but varied across geographic areas (n = 3 studies). Conclusion and recommendations: The prevalence of NCD risk factors in Ethiopia is relatively high. National NCD risk factor surveillance is required to inform the prioritisation of policies and interventions to reduce the NCD burden in Ethiopia.

Prevalence of Cigarette Smoking and Associated Factors among Residents of Hossana Town, Southern Ethiopia

BACKGROUND

Tobacco is the only legal product that kills a large number of its consumers when used as intended by producers. Information on cigarette smoking and associated factors among adults at the household level is very limited.

OBJECTIVE

To assess prevalence of cigarette smoking and associated factors among residents of Hossana town, Hadiya zone, Southern Ethiopia, 2020.

METHODS AND MATERIALS

A cross-sectional study design was performed. A structured questionnaire was used to collect data. Bivariate and multivariable binary logistic regression was used to identify risk factors of cigarette smoking. Variables significant at a p value of less than 0.05 were considered as independent predictors. Hosmer and Lemeshow test statistics were done to test the model fitness for the final model. Similarly, multicollinearity was checked by using collinearity statistics (tolerance and VIf).

RESULT

In total, 591 people responded to the survey, resulting in a 98.2% response rate. Among the study participants, cigarette smokers were 183 (31.0%). Educational status, alcohol use, and parental smoking were all found to have a significant relationship with cigarette smoking among research participants in Hosanna town. When compared to people with a college education or above, illiterates are approximately nine times more likely to consume cigarettes (95% CI = 9.058 (3.52, 22.469)). Alcoholics are about twice as likely as nondrinkers to smoke cigarettes (95% CI = 2.288 (1.548, 3.383)). Those who have cigarette-smoking parents are approximately twice as likely as their counterparts to smoke cigarettes (95% CI = 2.288 (1.548, 3.383)).

CONCLUSION

According to this survey, the prevalence of cigarette smoking was high. Furthermore, cigarette smoking was linked to illiteracy, alcohol consumption, and parental smoking in this study.

Tobacco use and associated factors among adults reside in Arba Minch health and demographic surveillance site, southern Ethiopia: a cross-sectional study

BACKGROUND

Tobacco use is one of the world-leading preventable killers. There was a varied prevalence of tobacco use and cigarette smoking across different areas. The aim of the study was to assess the prevalence and factors associated with current tobacco use among adults residing in Arba Minch health and demographic surveillance site (HDSS).

METHODS

A community-based cross-sectional study was conducted among adults residing in Arba Minch HDSS in 2017. The estimated sample size was 3368 individuals which were selected by simple random sampling techniques using Arba Minch HDSS dataset. Data collection tools were obtained from the WHO STEPwise. Current use of tobacco, which defined as the current use of smoked and/or smokeless tobacco, was considered as the dependent variable. A binary logistic regression model was used to identify candidate variables for the multivariable logistic regression model. An adjusted odds ratio (AOR) at a p-value of less than 0.05 was used to determine a statistically significant association between independent and dependent variables.

RESULT

The prevalence of tobacco use among adults was 20.2% (95% CI: 18.9-21.6%). The current use of smoked and smokeless tobacco were 17.1% (95%CI: 15.8-18.4%) and 9.7% (95%CI: 8.8-10.8%), respectively. The current use of tobacco was significantly associated with sex (female [AOR 0.54; 95%CI: 0.42-0.68] compared to men), age group (35-44 [AOR 1.57; 95%CI: 1.14-2.17], 45-54 [AOR 1.99; 95%CI: 1.45-2.74], and 55-64 [AOR 3.26; 95%CI: 2.37-4.48] years old compared to 25-35 years old), physical activity (moderate physical activity level [AOR 0.65; 95%CI: 0.44-0.96] compared with low) and residency (highland [AOR 4.39; 95% CI: 3.21-6.01] compared with at lowlander). Also, heavy alcohol consumption (AOR 3.97; 95% CI: 3.07-5.12), and Khat chewing (AOR 3.07(95%CI: 1.64-5.77) were also associated with the use of tobacco among the study participants.

CONCLUSION

Nearly one in five adults used tobacco currently in the study area, which is more than the national reports. Interventions for the reduction of tobacco use need to give due attention to men, older adults, uneducated, poor, and highlanders.

Tobacco smoking patterns in Samoa in 2010: Implications for interventions

INTRODUCTION

Tobacco use in Samoa has been described over time by age, sex and education, but little work exists on other sociodemographic factors associated with tobacco use. We describe current smoking and daily tobacco use in adults from Samoa, with a focus on sex and age stratified analyses of the influence of occupation, education, census region, household asset ownership and alcohol use in order to help develop potential targeted interventions.

METHODS

In 2010, a nationwide survey of 3745 adults aged 25–65 years from 33 villages was completed in Samoa. Current smoking status, daily tobacco use, as well as current alcohol use, and a variety of sociodemographic factors were assessed by interview. Bivariate and multivariable models, and sex and age group stratified analyses, were performed to determine different patterns of correlates.

RESULTS

More than half of all men (51.3%) and 21.8% of women were current tobacco smokers. Men and women smoked on average 10.9 and 8.7 cigarettes/day, respectively. Twenty per cent of men consumed ≥20 cigarettes/day. In men, being married, a subsistence-farmer/laborer, an alcohol user, and having low household assets, were independently associated with being a tobacco smoker (all p<0.01). Among women, not completing secondary education, being 25–34 years, residing in urban Apia, and being an alcohol user, were independently associated with being a tobacco smoker (all p<0.01).

CONCLUSIONS

Tobacco use in Samoa remains high and correlates of smoking suggest that interventions for cessation need to be developed within the contexts of sex, age, education, and household socioeconomic status.

Factors affecting tobacco smoking in Ethiopia: evidence from the demographic and health surveys

Background

Tobacco smoking is growing at an alarming rate in the developing world and sub-Saharan Africa. Although Ethiopia has a relatively low rate in the region, it is not immune to the tobacco epidemic. The government of Ethiopia passed an anti-tobacco bill in 2015 that includes measures governing tobacco consumption, advertising, packaging, and labeling. To effectively address the challenge of tobacco control, the government should consider a number of aspects of tobacco production and consumption, such as local production in rural areas, as well as the complementarity nature of tobacco and khat use.

Methods

Using the World Bank’s Demographic and Health Surveys (2011 and 2016), this paper analyzes the key determinants of tobacco smoking in Ethiopia, emphasizing possible differences in various social contexts, across regions. More specifically, we assess the association between khat use and tobacco smoking while controlling for various observed individual-level, household-level, and community-level covariates. Using GPS data, we are able to capture the neighboring effects of smoking behavior in community clusters bordering other administrative regions as well as differences in smoking patterns between lowland and highland residents. We utilize a multilevel modeling framework and use a two-stage residual inclusion estimation method that accounts for the endogeneity of khat and tobacco use.

Results

The results suggest that chewing khat and geographic regions are statistically significant determinants of tobacco smoking even after controlling for various socioeconomic and demographic factors. Altitude information analysis suggests that people living in lowlands are more likely to smoke compared to those living in highland areas. Additional analysis including interactions between regions and khat use indicate wide inter-regional variations in tobacco smoking by khat users. We also extend our analysis by interacting khat use with religious adherence. Results indicate a wide variation in tobacco smoking by khat chewers across different religious groups.

Conclusions

To effectively control tobacco smoking of the diverse communities in Ethiopia, policymakers should consider a multi-pronged policy approach that combines various policy tools that account for regional variation, the local social contexts, as well as the complementary nature of smoking and khat chewing practices.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-7200-8) contains supplementary material, which is available to authorized users.

Help seeking behavior for problematic substance uses in north-West Ethiopia

Background

Substance miss use and neuro-psychiatric conditions are a growing public health challenges, but 76 to 85% of people with those disorders in low and middle-income countries did not receive treatment. The aim of this study was to see help seeking behavior and determinant factors in residents with problematic substance uses.

Methods

A total of 2400 participants had screened for problematic substance uses and 548 participants were found positive for problematic substance uses. Then, we had interviewed 548 participants for help seeking behavior by pre-tested modified General Help Seeking Questionnaire. Logistic regression with its corresponding p-value < 0.05; Adjusted odds ratios (AOR) and 95% confidence intervals (CI) have been used.

Results

Among five hundred and forty-eight participants with problematic substance use, only one hundred and sixty-eight (30.7%) with 95% CI (27, 35%) had sought help. Age above 35 years [AOR = .47 95% CI (.25, .90)], who had common mental disorders [AOR = 4.12, 95% CI (2.7, 6.3)], who had comorbid medical condition [AOR = 3.0, 95% CI (1.7, 5.3)], and grand-families’ history of substance use [AOR = 2.18, 95% CI (1.4, 3.4)] were significantly associated with help seeking behavior.

Conclusion

Help-seeking behavior was infrequent in people with problematic substance use. Advanced age was a barrier to seek help while medical illnesses, common mental disorders and history of substance use in grand families were found to enforce to seek help.

An exploratory study of knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke among women in Aleta Wondo, Ethiopia

BACKGROUND

By 2030, the Sub-Saharan African region is projected to be the epicenter of the tobacco epidemic. While smoking prevalence is currently low among women (< 2%), the prevalence among men (7.7% overall and up to 27% depending on region) makes exposure to secondhand smoke a pressing concern for women and children. To prevent the uptake of smoking among women and address tobacco-related risks, including secondhand smoke exposure, a greater understanding of women's related perceptions is needed. The purpose of this study was to explore Ethiopian women's knowledge, attitudes, and beliefs related to tobacco use and secondhand smoke exposure, and the potential influence of contextual factors including; khat use, exposure to pro- and anti-tobacco messaging, and religious affiliation.

METHODS

A cross-sectional study using a systematic household sampling technique and an adapted interviewer-administered survey was conducted in Southern Ethiopia. The survey was administered to 353 women, 18-55 years of age, in Aleta Wondo town and surrounding districts between August-October 2014 (95.2% cooperation rate).

RESULTS

General awareness of harm associated with personal tobacco use and exposure to secondhand smoke was high (> 94%); however, specific knowledge of associated health-risks was limited. More than 96% perceived female tobacco use as socially unacceptable. At the same time, more than 70% were able to name potential benefits of using tobacco for both personal consumption and non-personal use. Respondents reported greater experimentation with khat versus tobacco and 73% reported that their religion significantly influenced their tobacco-related attitudes. Overall, there were higher reports of exposure to anti-tobacco (70%) versus pro-tobacco (49%) messaging, in the last 30 days.

CONCLUSIONS

The high level of awareness of health risks associated with tobacco use and SHS exposure and the high exposure to anti-tobacco messaging are community-level strengths that can proactively be built on to prevent the projected disease burden associated with tobacco. Findings have implications for the development of contextualized gender-specific tobacco control interventions, particularly in relation to the promotion of smoke-free homes.

The complications of treating chronic obstructive pulmonary disease in low income countries of sub-Saharan Africa

INTRODUCTION

In most low and middle-income countries, chronic obstructive pulmonary disease (COPD) is on the rise. Areas covered: Unfortunately, COPD is a neglected disease in these countries. Taking sub-Saharan Africa as an example, in rural areas, COPD is even unknown regarding public awareness and public health planning. Programs for the management of COPD are poorly developed, and the quality of care is often of a low standard. Inhaled medication is often not available or not affordable. Tobacco smoking is the most common encountered risk factor for COPD. However, in sub-Saharan Africa, household air pollution is another major risk factor for the development of COPD. Communities are also exposed to a variety of other risk factors, such as low birth weight, malnutrition, severe childhood respiratory infections, occupational exposures, outdoor pollution, human-immunodeficiency virus and tuberculosis. All these factors contribute to the high burden of poor respiratory health in sub-Saharan Africa. Expert commentary: A silent growing epidemic of COPD seems to be unravelling. Therefore, prevention and intervention programs must involve all the stakeholders and start as early as possible. More research is needed to describe, define and inform treatment approaches, and natural history of biomass-related COPD.

Prevalence of Smoking and Associated Factors: Evidence From the CHILILAB Demographic Surveillance System in Vietnam

This study analyzed secondary data from Chi Linh Health and Demographic Surveillance System (CHILILAB) database to identify smoking prevalence and associated demographic factors. Data were extracted from the database of the CHILILAB 2016, which included information on individual smoking behaviors, as well as individual and household demographic data. Descriptive and binary logistic regression analyses were performed with significance level of 0.05. The smoking prevalences were 34.7%, 0.9%, and 16.1% for men, women, and both genders, respectively. A total of 78.2% of current smokers smoked daily inside their houses. Lower smoking status was associated with younger age, being student, rich, and/or single. Future efforts should not only spend on further reduction of smoking rate in Chi Linh Town but should also pay special attention on reducing the prevalence of in-home smoking. This will help to decrease the risk of nonsmokers being exposed to secondhand smoke in their home environment.

Tobacco dependence among people with mental illness: a facility-based cross sectional study from Southwest Ethiopia

BACKGROUND

Tobacco smoking is a health care issue in developed as well as in developing countries. Tobacco smoking among people with mental illness is significantly higher than in the general population. Tobacco smoking has negative effects on physical, mental and financial well-being of people with mental illness but little is known about tobacco dependence among mental health service users in sub-Saharan African countries, including Ethiopia. Therefore, this study attempted to assess the prevalence of tobacco dependence and associated factors among mental health service users at Jimma University teaching hospital.

METHODS

A cross-sectional study was conducted among 305 male and 117 female mental health service users at Jimma University teaching Hospital in 2014. The Fagerstrom Test for Nicotine Dependence (FTND) was used to assess tobacco dependence. Logistic regression analysis was used for bivariate and multivariate analysis. Variables with a P value of <0.05 were considered to be associated with tobacco dependence in the final model.

RESULTS

The prevalence of current tobacco dependence among the study participants was 18.5%. Amongst people with tobacco dependence, 57.7, 29.5 and 12.8% had moderate, high and very high level of tobacco dependence respectively. All mental health service users with tobacco dependence were males. There was a significant association between tobacco dependence and high school education (AOR 3.02, 95% CI 1.07, 8. 48), alcohol use disorder (AOR 4.14, 95% CI = 1.54, 11.11), daily khat chewing (AOR 13.51, 95% CI = 4.27, 42.74), chewing khat 2-3 times per week (AOR 5.09, 95% CI = 1.37,18.95), chewing khat once a week (AOR 4.31, 95%CI = 1.04,17.78), having friends who smoke tobacco (AOR 4.88, 95% CI = 2.12, 11.25) and being diagnosed with schizophrenia compared to a diagnosis of major depression (AOR 5.26, 95% CI = 2.07, 13.37). However, daily attendance at a place of worship (AOR 0.46, 95% CI = 0.22, 0.95) was associated negatively with tobacco dependence.

CONCLUSION

In this study, there was a high prevalence of tobacco dependence among mental health services users. There is a pressing need to increase availability of psychological and pharmacological interventions to reduce tobacco dependence and tobacco-related medical illness in this vulnerable group.

Prevalence and factors that influence smokeless tobacco use among adults in pastoralist communities of Borena Zone, Ethiopia: mixed method study

BACKGROUND

Deaths due to tobacco consumption are on the rise, from 5.4 million in 2005 to 6.4 million in 2015 and 8.3 million in 2030 of which more than 80% will be in developing countries. Smokeless tobacco use is a significant health risk and cause of disease. Over 300 million people use smokeless tobacco worldwide. More than 250 million adult smokeless tobacco users are in low- and middle-income countries, the total burden of smokeless tobacco use is likely to be substantial. In Ethiopia, nationally representative data on the smokeless tobacco use is not available. Most studies conducted in the country focused on cigarette smoking.

METHOD

A community based cross-sectional study using quantitative and qualitative approaches was conducted from September 14-29, 2015. The study was conducted among adults in pastoralist communities in Borena zone, Ethiopia. A total of 634 households were selected randomly for interview. An interviewer-administered questionnaire and in-depth interview guide was used to assess adults' practice, attitude, knowledge, and perception on Smokeless Tobacco use. Logistic regression was used to assess association between dependent and independent variables.

RESULT

Out of 634 participants, 287 (45.3%) of them were current users of smokeless tobacco. Being Muslim (AOR = .21, 95% CI: .13, .33), being Christian (AOR = .38, 95% CI: .22, .67), and having good health risk perception toward smokeless tobacco use (AOR = .49, 95% CI: .34, .70) were protective factors for smokeless tobacco use, whereas favorable attitude (AOR = 2.12, 95% CI: 1.48, 3.04) and high social pressure towards smokeless tobacco use (AOR = 1.73, 95% CI: 1.21, 2.47) were factors independently associated with smokeless tobacco use.

CONCLUSION

This study concludes that smokeless tobacco use is very common in the selected districts of the Borena zone. The practice is strong linked to the lifestyle of the community.

Psychological morbidity and substance use among patients with hypertension: a hospital-based cross-sectional survey from South West Ethiopia

BACKGROUND

Psychological morbidity and substance use disorders have been linked to cardiovascular diseases; affecting patients' medical outcome and quality of life. However, little is known about psychological morbidity and substance use among patients with hypertension in Ethiopia. Therefore, we aimed to assess psychological comorbidity and substance use among hypertensive patients in Southwest Ethiopia.

METHODS

A cross-sectional study was conducted among 396 hypertensive patients on follow-up at Jimma University Teaching Hospital in Ethiopia during the study period. Structured questionnaires were used to assess alcohol use, khat chewing and cigarette smoking. Psychological morbidity was assessed using the Kessler-6 scale. Multiple logistic regression analysis was carried out to identify the independent association between outcome and explanatory variables.

RESULTS

The prevalence of psychological morbidity among hypertensive patients was 31.6%. Of the total participants, 31 (7.8%) of them had alcohol use disorders and 79 (19.9%) of them were using khat regularly at the time of the study. Singles were more likely to have psychological morbidity than married participants (AOR = 4.72; 95% CI 1.83, 12.20, p = 0.001), whereas those who were able to 'read and write' were less likely to have psychological morbidity than non-literate ones (AOR = 0.46; 95% CI 0.24, 0.89, p = 0.02). However, no association was seen between psychological morbidity and substance use (khat chewing, alcohol use and cigarette smoking), belief about hypertension, ever discontinuation of medication and lifestyle (exercise, salt consumption).

CONCLUSION

Psychological morbidity and substance use are prevalent among hypertensive patients on follow-up at the hospital. The findings of the study imply that there is a need for further studies to understand the effect of psychological morbidity on the clinical outcomes of hypertensive patients.

Factors associated with secondhand tobacco smoke in the home: an exploratory cross-sectional study among women in Aleta Wondo, Ethiopia

BACKGROUND

In Ethiopia, female smoking rates are currently low (1 %). However, because of male smoking rates (overall 7.7 % and up to 27 % depending on region), women and children's risk of second hand smoke (SHS) exposure is a pressing concern. In order to develop effective public health interventions that prevent the uptake and exposure to smoking, thereby averting the projected increase in tobacco-induced disease, an understanding of Ethiopian women's practices regarding tobacco is needed. The purpose of this study was to explore Ethiopian women's tobacco use and prevalence of SHS exposure, and to identify covariates associated with SHS exposure.

METHODS

We conducted an exploratory cross-sectional study in Southern Ethiopia between August and October 2014, and systematically sampled households in Aleta Wondo town and surrounding districts. Trained interviewers verbally administered surveys to women 18-55 years of age. Descriptive statistics and multiple logistic regression analyses were performed.

RESULTS

None of the 353 participants reported current tobacco use and less than 1 % reported ever use, however, 11 % reported ever use of the stimulant leaf khat. Twenty-seven women (7.6 %) reported living with a tobacco user, however, twice that number (14.4 %) overall, and 22 % of urban participants reported that smoking occurred daily in their home. When controlling for other factors, living with a tobacco user (OR = 9.91, 95 % CI [3.32, 29.59]), allowing smoking in the home (OR = 5.67, 95 % CI [2.51, 12.79]), place of residence (OR = 2.74, 95 % CI [1.11, 6.74)]), and exposure to point-of-sale advertising within the last 30 days (OR = 2.87, 95 % CI [1.26, 6.54]) contributed significantly to a model predicting the likelihood of reporting daily occurrence of smoking/SHS in the home.

CONCLUSIONS

While few women reported having ever used tobacco, one in seven women in this study reported that smoking/SHS occurred daily in their homes. Therefore SHS exposure is a potential health concern for women and children in this rural community. Findings from this study provide baseline data for monitoring tobacco control policies in Ethiopia, particularly in relation to the promotion of smoke-free homes, and could be used to inform prevention program development.

The prevalence of and factors associated with current smoking among College of Health Sciences students, Mekelle University in northern Ethiopia

Background

Tobacco smoking is one of the greatest causes of preventable morbidity and mortality globally, and is responsible for many causes of untimely deaths. This survey was aimed to determine prevalence and factors associated with current smoking among the students of College of Health Sciences, Mekelle University, Ethiopia.

Methods

A cross-sectional study was employed using a structured self-administered questionnaire among College of Health Sciences students in March 2013. A stratified random sampling method was employed to select study participants. Data were entered and analysed using of Statistical Package for Social Sciences (SPSS) version 20.0.

Results

Of the 193 students, 57 (29.5%) of the students were current smokers. Most of the current smokers (89.4%) smoked between 1–10 sticks of cigarette per day. The two main reasons cited for smoking cigarettes were peer pressure (43.9%) and to relieve stress (36.8%). Being female (adjusted OR [AOR] = 0.49; 95% CI: 0.25, 0.95) and Tigre by ethnicity (AOR = 0.32; 95% CI: 0.14, 0.74) were significantly less associated with current smoking. On the other hand, being second year students (AOR = 3.84; 95% CI: 1.41, 10.46), khat chewing (AOR = 8.36; 95% CI: 2.60, 26.85) and taking illicit drugs (AOR = 10.59; 95% CI: 2.77, 40.51) were positively associated with current smoking cigarettes.

Conclusions

The current smoking prevalence among students in College of Health Sciences, Mekelle University is high and therefore, effective smoking prevention and cessation intervention programs are required to reduce smoking among university students.