Comparisons and correlates of smoking among young men in 13 sub-Saharan countries

Youth are critical targets for smoking-cessation programs because most adult smokers initiate smoking during youth. Smoking tends to be associated with other harmful behaviors, such as alcohol use. However, few studies have documented the smoking habits of youth in the developing countries. Using data from the Demographic and Health Surveys conducted during 2003-2006, this study examines socioeconomic, household and neighborhood factors that are associated with smoking among young men (age 15-24) in 13 countries in sub-Saharan Africa. The percentage who currently smokes tobacco ranged from 2% in Ghana to 35% in Madagascar. In all countries, at the bivariate level, smoking was significantly higher (p<0.05) among older (age 20-24) youth, ever-married youth, those currently working, those who were the head of household, those who lived in a household headed by a youth, and those who lived in a neighborhood where smoking levels were high. Smoking was also significantly positively associated with current use of alcohol and with lack of adult supervision in several countries. The effects of urban/rural residence, media exposure, sex of the household head, household wealth, and control over earnings were largely inconsistent across countries. Logistic regression models show that across all countries, older youth, youth with secondary or higher education, those currently working, and those who lived in neighborhoods with high smoking levels were significantly more likely to be current smokers. The association with alcohol use also remained significant in most countries. Findings suggest various youth groups that can be targeted by smoking cessation programs in sub-Saharan Africa.