Trends in the use and dual use of factory-made combustible cigarettes, other tobacco products and electronic cigarettes: Results from South African Social Attitudes Surveys during 2007 to 2018

Catherine O Egbe; Siphesihle Gwambe; Mukhethwa Londani; Olufemi Erinoso; Olalekan A Ayo-Yusuf

doi:10.18332/tid/168121

Trends in the use and dual use of factory-made combustible cigarettes, other tobacco products and electronic cigarettes: Results from South African Social Attitudes Surveys during 2007 to 2018

Tob Induc Dis. 2023 Jul 17:21:94. doi: 10.18332/tid/168121. eCollection 2023.

Authors

Catherine O Egbe^{1

2}, Siphesihle Gwambe¹, Mukhethwa Londani^{1

3}, Olufemi Erinoso⁴, Olalekan A Ayo-Yusuf⁵

Affiliations

¹ Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa.
² Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
³ Directorate of Research and Innovation, Tshwane University of Technology, Pretoria, South Africa.
⁴ School of Public Health, University of Nevada, Reno, United States.
⁵ Africa Centre for Tobacco Industry Monitoring and Policy Research, School of Health System and Public Health, University of Pretoria, Pretoria, South Africa.

Abstract

Introduction: Using more than one tobacco product increases the risk of tobacco-related diseases. We investigated trends in the prevalence and dual use of factory-made (FM) cigarettes, other tobacco products, and electronic cigarettes (e-cigarettes) in South Africa over a 12-year period.

Methods: Data from five waves (2007, 2010, 2011, 2017, and 2018) of the South African Social Attitudes Survey (n=14582) were analyzed. The use of FM, roll-your-own (RYO) cigarettes, cigars, waterpipe, smokeless tobacco (SLT), any combustible tobacco products (CTP), any tobacco product (ATP) use, and e-cigarettes was investigated. The dual use of FM cigarettes with either SLT, waterpipe or e-cigarettes was also explored. Chi-squared analyses and regression models were used to explore trends in prevalence over the 12-year period.

Results: About 51% of the participants were female, and 51.9% were aged 16-34 years. CTP smoking significantly increased from 18.1% (2010) to 23.6% (2018) (p=0.015), while ATPU increased from 20.2% (2010) to 25.9% (2018) (p=0.005). Though dual use of FM cigarettes and SLT, waterpipe, or e-cigarettes was generally low, the prevalence of dual use significantly increased for all product combinations investigated: FM cigarettes and SLT (0.5% in 2007 to 1.3% in 2018, p=0.017), FM cigarettes and waterpipe (0.9% in 2010 to 2.5% in 2018, p=0.014), FM cigarettes and e-cigarettes (0.4% in 2010 to 1.8% in 2018, p<0.001). Compared to 2010, the odds of the prevalence of CTP and ATP use significantly increased by 37% in 2018 (adjusted odds ratio, AOR=1.37; 95% CI: 1.06-1.77; p=0.018 and AOR=1.37; 95% CI: 1.08-1.73; p=0.009, respectively) during the 12-year period after adjusting for demographic characteristics.

Conclusions: The use and dual use of tobacco and electronic cigarette products have been increasing in recent years in South Africa. Interventions to help users quit and prevent young people from initiating use are urgently needed to curb these increases.

Keywords: South Africa; combustible tobacco; dual product use; e-cigarettes; tobacco use.