ArticleBMC public health2021
Prevalence and socio-demographic correlates of tobacco and alcohol use in four sub-Saharan African countries: a cross-sectional study of middle-aged adults.
Article in BMC public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Tobacco smoking in Sub-Saharan Africa: A systematic review and meta-analysis.Drug and alcohol review · 2025Pooled it
- Alcohol Consumption Patterns: A Systematic Review of Demographic and Sociocultural Influencing Factors.International journal of environmental research and public health · 2022Pooled it
- Daily Predictors of Intimate Partner Violence Perpetration Among Adolescent Boys in Soweto, South Africa: A Mixed-Methods Study.Violence against women · 2026Article
- Determinants of tobacco use among men aged 15 to 59 in Sub Sahara Africa: a multilevel mixed effect logistic regression analysis.BMC public health · 2026Article
- Hypertension Incidence and Its Risk Factors in a Longitudinal Cohort of Middle-Aged Men and Women Living in Urban South Africa.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Prevalence and factors associated with substance use among adolescent girls and young women working in artisanal and small-scale gold mining communities of Uganda: a cross-sectional exploratory study.Substance abuse treatment, prevention, and policy · 2026Article
- "Cigarettes led me back to smoking tik": lived experience perspectives on tobacco use during substance use treatment and recovery in South Africa.Addiction science & clinical practice · 2026Article
- Pre- and during -COVID-19 pandemic mortality trends and drivers in rural, coastal Kenya: findings from the Kaloleni-Rabai Health and Demographic Surveillance System.Population health metrics · 2025Review
- Social determinants of hazardous alcohol use in a Ugandan population cohort.Global health action · 2025Article
- Prevalence, Determinants, and Time Trends of Cardiovascular Health in the WHO African Region.JAMA cardiology · 2025Article
- Head and Neck Cancer: Trends and Geographical Distribution of Head and Neck Cancer at a Tertiary Hospital in Northern Tanzania.Laryngoscope investigative otolaryngology · 2025Article
- Exploring explainable machine learning algorithms to model predictors of tobacco use among men in Sub Sahara Africa between 2018 and 2023.Scientific reports · 2025Article
- Alcohol consumption among persons living with hypertension: evidence from a population-based study in Cape Verde.BMC public health · 2025Article
- Self-reported hypertension prevalence, risk factors, and knowledge among South Africans aged 24 to 40 years old.Journal of human hypertension · 2025Article
- Perceived oral health and disease experience among adults in Sierra Leone: An exploratory study.Journal of public health in Africa · 2025Article
- A nonlinear decomposition analysis of the rural-urban disparities in tobacco use among women in sub-Saharan Africa.PloS one · 2025Article
- Prevalence and correlates of common mental disorders among participants of the Uganda Genome Resource: Opportunities for psychiatric genetics research.Molecular psychiatry · 2025Article
- Cohort Profile: Africa Wits-INDEPTH partnership for Genomic studies (AWI-Gen) in four sub-Saharan African countries.International journal of epidemiology · 2024Article
- HIV Stigma, Health, and Violence: A Longitudinal Study among Adolescent Boys with HIV in Soweto, South Africa.AIDS and behavior · 2024Article
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Corrections and comments
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Authors and funding
15 authors at 5 institutions in 4 countries.
Funding
Abstract
backgroundSubstance misuse is a global public health problem. In addition to social and economic concerns, consumption of tobacco and alcohol is associated with susceptibility to cardiovascular, respiratory, and infectious diseases, cancers, and risk of transition to substance use disorders. African data suggest regional differences in the prevalence and patterns of substance use, but a number of key questions remain. This cross-sectional population-based study of middle-aged adults aims to examine prevalence and socio-demographic correlates of substance use in four sub-Saharan African countries, in rural and urban settings.
methodsParticipants aged between 40 and 60 years were recruited from six research centres as part of the Africa Wits-INDEPTH partnership for Genomic Research study. Data on patterns of tobacco and alcohol consumption was captured, and the latter further assessed using the CAGE (cut-annoyed-guilty-eye) questionnaire.
resultsData from 10,703 participants suggested that more men (68.4%) than women (33.3%) were current substance users. The prevalence of current smoking was significantly higher in men than in women (34.5% vs 2.1%, p < 0.001). Smokeless tobacco was used more by women than men (14.4% vs 5.3%, p < 0.001). Current smoking was associated with alcohol consumption in men, and smoking cessation in men was associated with being a former drinker, having higher socio-economic status, and if married or cohabiting. Current alcohol consumption was higher in men, compared to women (60.3% vs 29.3%), and highest in men from Soweto (70.8%) and women from Nanoro (59.8%). The overall prevalence of problematic alcohol consumption among men was 18.9%, and women 7.3%. Men were significantly more likely to develop problematic drinking patterns, and this was more common in those who were divorced or widowed, and in current smokers.
conclusionsRegional variation in the patterns and prevalence of substance use was observed across study sites, and in rural and urban settings. The high levels of substance use recorded in this study are of concern due to the increased risk of associated morbidities. Further longitudinal data will be valuable in determining trends in substance misuse in Africa.
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