Tobacco use patterns and associated factors among the youth in informal settlements in Kampala: a case study of Bwaise

Abstract

Tobacco use among the youth in Uganda remains higher than general national estimates. To tackle this challenge, the CTCA and WHO assert a need for current data and tobacco use monitoring with emphasis on most at-risk populations. In Uganda, routine monitoring is done through quinquennials; UDHS, WHO-STEPS surveys, GATS and GYTS. Although recent assessments reported tobacco use among the general population, there is a dearth of current data among the youth in informal settlements, a most at-risk population for tobacco use. This study sought to assess the patterns of tobacco use and associated factors among the youth using Bwaise as a case study. Objective: To assess the patterns of tobacco use and associated factors among the youth in Bwaise informal settlement in Kampala, Uganda so as to generate evidence to facilitate interventions for tobacco use control in urban informal settlements. Methods: This was a cross-sectional study which utilised quantitative methods. Secondary data from a previous study that aimed at determining motivators of persistent tobacco use and cessation barriers among the youth in Bwaise was used. The data was collected between March 2021 to April 2021 among 422 youth aged 18-30 in Bwaise. It was analysed using STATA version 17.0. Modified Poisson regression with robust standard errors was used to assess for associations. Results: The majority were males (58.8%), 160/422 (37.9%) were daily smokers and 69/422 (16.4%) were smokeless tobacco users. ‘Kibanga’ was the most smoked product (145/160) daily. Being male (adj.PR=1.68 [95%CI=1.27-2.23]), aged 21-30 years (adj.PR=1.72 [95% CI=1.28-2.33]), of education below secondary (adj.PR=0.69[95%CI=0.56-0.87]), of origin from central Uganda (adj.PR=0.64[95%CI=0.46-0.89]), not knowing that smoking causes serious illness (adj.PR=1.5[95%CI=1.11-2.03]), heart attacks (adj.PR=1.49[95%CI=1.11-4.83]) and lung cancer (adj.PR=1.71[95%CI=1.25-2.35]) were all significantly associated with daily tobacco smoking. Being aged 21-30 years (adj.PR=1.75 [95%CI=1.04-2.96]), not believing that smoking causes heart attacks and not knowing that smokeless tobacco causes serious illness (adj.PR=3.02 [95%CI=1.87-4.87]) were significantly associated with smokeless tobacco use. Conclusions and recommendations: Daily tobacco smoking and smokeless tobacco use prevalence were both higher than the national estimates. Current and future interventions should target males aged 21-30 years, of education level below secondary, originating from central Uganda as well as address knowledge gaps on the dangers of tobacco use.