Tobacco and Public Health - TCSC Indonesia

In assessing tobacco use in Africa it is important to include both smoked and smokeless
tobacco (snuff, toombak). In Senegal, for instance, although 32 per cent of adults
use some form of tobacco only 4.6 per cent smoke manufactured cigarettes (Corrao
et al. 2000). Similarly, in South Africa, as many women use snuff as smoke cigarettes
(about 10 per cent).
The Global Youth Tobacco Survey (GYTS) (National Center for Disease Prevention
and Health Promotion 2002)—a series of school-based surveys conducted between
1999 and 2001 in selected countries—confirm that a diversity of tobacco products are
used in the region. The surveys reveal that tobacco use is common among 13–15-yearolds,
with about one in five school children regularly using tobacco at the time of the
survey. Manufactured cigarettes were not the main form of tobacco used—only one in
twelve children were current cigarette smokers. The gap between male and female
tobacco use was surprisingly small (Table 15.1).
The data on the prevalence of tobacco use in Africa should be regarded with caution,
as information is not available for many countries and even when available it is frequently
not nationally representative. Most surveys of smoking behaviour usually only
cover the major cities or selected sub-regions. The need for accurate information on
the use of tobacco and its health consequences in Africa has long been recognized
(Sasco 1990) but little has been done to address this need.
Tobacco and health
YUSSUF SALOOJEE 269
The existing African per capita cigarette consumption rate is the same as that in the
industrialized countries in the 1920s. As a result, SSA is the only region of the world in
which primary prevention of the tobacco epidemic is possible. Currently, tobacco use
is not a major cause of death on the continent. AIDS, malaria, tuberculosis, maternal
and perinatal conditions, and measles remain the major killers.
Table 15.1 Tobacco and cigarette use among school children in selected African countries
Country (city/region) Current tobacco user (%) Current cigarette user (%)
All Males Females All Males Females
Ghana (national) 19.3 19.5 18.8 4.8 5.3 3.8
Kenya (national) 13.0 15.8 10.0 7.2 10.1 4.2
Mali (Bamako) 31.2 44.9 12.6 11.2 11.4 10.1
Malawi (Lilongwe) 18.2 21.1 14.7 6.2 9.1 2.8
Nigeria (Cross River State) 22.1 23.9 17.0 9.1 9.7 5.7
Zimbabwe (Manicaland) 22.0 23.0 20.0 11.4 12.6 9.7