Inequalities in successful tobacco cessation and tobacco cessation attempts: Evidence from eight Sub-Saharan African countries

PLoS One. 2022 Nov 22;17(11):e0277702. doi: 10.1371/journal.pone.0277702. eCollection 2022.

Abstract

Background: Tobacco consumption is a contributing and modifiable risk factor for non-communicable diseases. In high-income countries, tobacco cessation attempts, and their success, are concentrated among the socio-economically advantaged, resulting in a skewed burden of disease. However, there is a paucity of evidence on the distribution of tobacco cessation in low- and middle-income countries.

Objective: The objective of this study is to measure and decompose wealth- and education-related inequalities in tobacco cessation in eight Sub-Saharan African countries.

Methodology: The study applies Erreygers' corrected concentration indices and decomposition methods to the most recent Global Adult Tobacco Surveys in Botswana, Cameroon, Ethiopia, Kenya, Nigeria, Senegal, Tanzania, and Uganda.

Findings: We find that across countries, successful tobacco cessation, as well as tobacco cessation attempts, are concentrated among wealthier and better-educated individuals. Differences in socio-economic status, urban or rural residence, and not knowing or believing that tobacco consumption leads to serious illness contributes to these inequalities.

Conclusion: Governments in our sample of countries can do more to support socio-economically disadvantaged smokers in their efforts to quit smoking, including by making an effort to align each country's smoking cessation strategy with the guidelines outlined in the World Health Organization's Framework Convention on Tobacco Control.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ethiopia
  • Humans
  • Smokers
  • Smoking
  • Smoking Cessation*
  • Tobacco Use Cessation*

Grants and funding

This study was funded by the Bill & Melinda Gates Foundation through the African Capacity Building Foundation (grant number 334). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.