Prevalence, patterns, and factors associated with tobacco use among patients with priority tobacco related illnesses at four Kenyan national referral hospitals, 2022

Valerian Mwenda; Lazarus Odeny; Shukri Mohamed; Gladwell Gathecha; Anne Kendagor; Dorcas Kiptui; Florence Jaguga; Beatrice Mugi; Caroline Mithi; Kennedy Okinda; Daniel Mwai; David Njuguna; Winnie Awuor; Rachel Kitonyo-Devotsu; Jane Rahedi Ong'ang'o

doi:10.1371/journal.pgph.0002002

Prevalence, patterns, and factors associated with tobacco use among patients with priority tobacco related illnesses at four Kenyan national referral hospitals, 2022

PLOS Glob Public Health. 2023 Nov 10;3(11):e0002002. doi: 10.1371/journal.pgph.0002002. eCollection 2023.

Authors

Affiliations

¹ Department of Non-communicable Diseases, Ministry of Health, Nairobi, Kenya.
² Kenya Medical Research Institute, Nairobi, Kenya.
³ African Population and Health Research Center, Nairobi, Kenya.
⁴ Moi Teaching and Referral Hospital, Eldoret, Kenya.
⁵ Kenyatta National Hospital, Nairobi, Kenya.
⁶ Kenyatta University Teaching, Referral and Research Hospital, Nairobi, Kenya.
⁷ Kenyatta National Hospital-Othaya Referral Hospital, Othaya, Kenya.
⁸ University of Nairobi, Nairobi, Kenya.
⁹ Department of Planning and Health Financing, Ministry of Health, Nairobi, Kenya.
¹⁰ Development Gateway, Nairobi, Kenya.

Abstract

Tobacco use is a risk factor for many chronic health conditions. Quantifying burden of tobacco use among people with tobacco-related illnesses (TRI) can strengthen cessation programs. This study estimated prevalence, patterns and correlates of tobacco use among patients with TRI at four national referral hospitals in Kenya. We conducted a cross-sectional study among patients with five TRI (cancer, cardiovascular diseases, cerebrovascular disease, chronic obstructive pulmonary disease, and pulmonary tuberculosis) during January-July 2022. Cases identified from medical records were interviewed on socio-demographic, tobacco use and cessation information. Descriptive statistics were used to characterize patterns of tobacco use. Multiple logistic regression models were used to identify associations with tobacco use. We identified 2,032 individuals with TRI; 46% (939/2,032) had age ≥60 years, and 61% (1,241/2,032) were male. About 45% (923/2,032) were ever tobacco users (6% percent current and 39% former tobacco users). Approximately half of smokers and 58% of smokeless tobacco users had attempted quitting in the last month; 42% through cessation counselling. Comorbidities were present in 28% of the participants. Most (92%) of the patients had been diagnosed with TRI within the previous five years. The most frequent TRI were oral pharyngeal cancer (36% [725/2,032]), nasopharyngeal cancer (12% [246/2.032]) and lung cancer (10% [202/2,032]). Patients >60 years (aOR 2.24, 95% CI: 1.84, 2.73) and unmarried (aOR 1.21, 95% CI: 1.03, 1.42) had higher odds of tobacco use. Female patients (aOR 0.35, 95% CI: 0.30, 0.41) and those with no history of alcohol use (aOR 0.27, 95% CI: 0.23, 0.31), had less odds of tobacco use. Our study shows high prevalence of tobacco use among patients with TRI in Kenya, especially among older, male, less educated, unmarried, and alcohol users. We recommend tobacco use screening and cessation programs among patients with TRI as part of clinical care.

Copyright: © 2023 Mwenda et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Grants and funding

The work was supported by the Development Gateway to RD, through a grant from Bill & Melinda Gates Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.