An interesting study directed by Desalu Olufemi published on the Internet Journal of Epidemiology.
More than a third of
this study population smokes tobacco as cigarette or pipe. This is
worrisome and is a great cause for concern because of its negative
impact on the health of our population. The result from the Nigerian
tobacco survey in 2002 is a gross underestimation of tobacco use. The
problem of underestimation is an issue in most of developing countries
in sub-Saharan Africa and Asia
The prevalence of male smoking was 45.3% while female was 18.4% giving a ratio of 3 to1, this is similar to many other studies,
This is a pioneer population based study with large sample size in adults of North-eastern part of Nigeria. Most of the studies done in Nigeria are in specific groups like the females gender, students of educational institution, doctors and armed forces personnel in the society.
Tobacco smoking in this study population was 37.9%, the prevalence of current tobacco smoking was 31.9% and ex- tobacco smoking was 6.0%. The prevalence of current smoking in this study was higher when compared with the national survey carried out in 2002 which was 8.6% and 17.6% among rural dwellers in south-west Nigeria but is closer to 32.0% in Senegal, 35.7%,37.0% in Benin and Cameroon respectively who were our geographical neighbours in West Africa . The geographical variation in these results might be because of the different definition of current smoker adopted in the various studies. More than a third of this study population smokes tobacco as cigarette or pipe. This is worrisome and is a great cause for concern because of its negative impact on the health of our population. The result from the Nigerian tobacco survey in 2002 is a gross underestimation of tobacco use. The problem of underestimation is an issue in most of developing countries in sub-Saharan Africa and Asia
The prevalence of male smoking was 45.3% while female was 18.4% giving a ratio of 3 to1, this is similar to many other studies, but different from Guinea in West Africa and the developed countries can cannot overlook the high prevalence of tobacco smoking in the female population which is similar to 19% in United State of America . This trend may due to the strong tobacco advertisement by multinational company directed toward women in educational institutions and the markets as well as poor control strategies by the authorities.
The socioeconomic status of a person is determined by the income, occupational class and educational attainment. By stratifying the respondents into low and high socioeconomic class 84.1% of the current smokers belong to low socioeconomic class while 15.9% belongs to high socioeconomic class. This result is similar to reports from India . The reason many poor people smoke is that they see tobacco as a “reward”, and perhaps feel that they have less to lose from future illness, because they see no future to look forward to or for which to plan. The mean age of the tobacco smoker was 36.6 ± 10.4years and the average age of starting tobacco smoking was 18.6± 5.1years. This is similar to study of rural dwellers in South-West Nigeria but less than 20.5 years in India . The early age of tobacco smoking in the developed countries may connected to the degree of youth freedom and the moral and religious value attached to smoking. The knowledge about the age of starting smoking would help the policy maker in channelling the limited resources on tobacco cessation programme at the adolescent. More than half of the current smokers are mild smoker (smokes 1-10 sticks each day) and the mean cigarette consumption is 10 ± 2 sticks each day. The rate of consumption in our study was similar to other survey in Nigeria but less than the consumption rate in the Middle East and America
This consumption rate in our study put the smoker in a category of people that are likely to respond positively to tobacco cessation therapy. Almost a third of the ever- smoker (31.6%) smokes Benson and hedges brand of cigarette,12.1% smokes Aspen brand, Rothmans 10.9% and Saint Morris was 4.4% . This pattern of brand of cigarette smoked might be due to the presence and concentration of menthol and additive ingredients in the specific brand of cigarette. Peer pressure was main reason for starting tobacco smoking in a quarter of the smoker and in 20.6% social acceptance was the culprit. This result agrees with similar survey from Nigeria and based on this finding, the quitting programmes need to focus mostly on the early adolescents and socio-cultural societies.
This study has also revealed that 60.7% of the current smoker believes tobacco smoking is harmful to their health, 51.0% were previously advised to quit however only 33.9% have tried quitting tobacco use. The quitting percentage in our study was low when compared to 56.0% in Kuwait ; our findings may because of lack of awareness tobacco related diseases and poor health education in the North-Eastern Nigeria. About 53.7% of the former smoker quit due to ill health while13.0 % was because of social pressure and fewer than 2% quit due to cost of tobacco product. The low quitting rate of tobacco may be due to result of addiction, when nicotine addiction develops irrespective of socioeconomic status, efforts is made by the individual to satisfy himself. This study has shown that is a strong association between ever smoked tobacco and independent determinant of smoking like male gender, age range 40-4 , accompanying alcohol intake and belonging to Fulani, Hausa and Margi ethnic tribes. The prevalence of tobacco smoking among adult population in this region of Nigeria was high when compared to the result of the national survey done 6 years ago which grossly underestimate the burden of tobacco use in Nigeria. Besides, this study also found a high prevalence of smoking among the female gender. Because of the socio-cultural diversity of Nigeria and the population size of 140 million which is largest in Africa, it is important that a national survey of tobacco smoking similar to that of HIV be carried out in all the geopolitical zones of Nigeria. This comprehensive national survey would reveal the true picture of the burden of tobacco in Nigeria. Also the government and stakeholders needs to draft a tobacco control policy that adaptable to Nigeria and targeted at the adolescence and at risk groups to reduce tobacco related morbidity and mortality.
Acknowledgements
We the authors wish to recognise the support of the trained assistants and the students of state nursing school Yola who helped us the in data collection
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