Tobacco use and its determinants in the 2015 Kenya WHO STEPS survey

Abstract

BackgroundAccording to the World Health Organization (WHO), in 2015, over 1.1 billion people smoked tobacco, which represents around 15% of the global population. In Africa, around one in five adults smoke tobacco. The 2014 Kenya Global Adult Tobacco Survey reported that 2.5 million adults use tobacco products. The objective of our study was to describe patterns and determinants of tobacco use from the 2015 Kenya STEPS survey, including use of “smokeless” tobacco products and the more novel e-cigarettes.MethodsThe WHO STEPwise approach to surveillance (STEPS) was completed in Kenya between April and June 2015. Logistic regression analyses was used to assess factors affecting prevalence and frequency of tobacco use. Sociodemographic variables associated with tobacco use were considered: age, sex, level of education, wealth quintile, and residence. The relationship with alcohol as an intervening risk factor was also assessed. Our main outcomes of interest were current tobacco use, daily tobacco use and use of smokeless tobacco products.ResultsOf 4484 respondents, 605 (13.5%) reported being current tobacco users. Most active tobacco users were male (n = 507/605, 83.8%). Three out of four tobacco users (n = 468/605, 77.4%) reported being less than 50 years old, with the average start age being 21 (20.6, 95% CI 19.3–21.8) and the average quit age 27 (27.2, 95% CI 25.8–28.6). Most tobacco users had only ever attended up to primary school (n = 434/605, 71.7%). Men had nearly seven times higher odds of being tobacco users as compared to women (OR 7.63, 95% CI 5.63–10.33). Alcohol use had a positive effect on tobacco use. Finally, less than ten respondents reported having used e-cigarettes.ConclusionThe 2015 Kenya WHO STEPS provided primary data on the status of tobacco use in the country and other leading NCD risk factors, such as alcohol, and associated diseases. Our findings highlight key target populations for tobacco cessation efforts: young people, men, those with lower levels of education, and alcohol consumers. Further data is needed on the use of smokeless tobacco, and its impact on smoked tobacco products, as well as on the novel use of e-cigarettes.

The Scope of Tobacco Abuse in Kenya and Interventions Taken to Promote Cessation: A Review

“…Regrettably, above 80% of those who attempt to stop tobacco smoking find themselves relapsing to the same smoking habits [41] [42]. There are many associated benefits in quitting tobacco smoking; notably, improved health and reduced risk commonly associated with tobacco smoking diseases [43]. Quitting smoking is a slow process that involves stepwise consistent reduction of the urge to smoke; it is not an instant abstinence, but the benefits are Open Access Library Journal immediate and possibly realized in less than a month after quitting [38].…”

“…It is thus of critical significance that smokers get access to smoking cessation interventions and treatment. This encourages people to stop smoking and therefore exploit the smoker's probabilities of abandoning cigarette smoking successfully [43].…”

“…Behavioral interventions when used together with medication yields a high rate of successful smoking cessation [45]. Behavioural interventions involve counselling sessions by health providers as well as providing routine advice and consultations which are provided resourcefully to smokers [43].…”

“…Pharmacological interventions are a combination of two pronged mechanism include both nicotine based and non-nicotine based medications [43]. Nicotine replacement therapies (NRTs) are a pharmacological method that is normally approved by food and drug administration (FDA) [45].…”

“…Apart from NRT, other non-nicotine medications involve the use of bupropion or varenicline which have proved quite effective [34]. Bupropion has been found to lessen the desire to smoke cigarettes in clinical trials [43]. Bupropion works by inhibiting dopamine re-uptake into neuronal synaptic vesicles in nucleus accumbens [45].…”