ArticleBMJ open2026
Tobacco use and associated factors among adults in Ghana: evidence from the 2022 Ghana Demographic and Health Survey.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo examine the prevalence and sociodemographic factors associated with tobacco smoking, smokeless tobacco and dual use among adults in Ghana using the 2022 Demographic and Health Survey (GDHS).
settingGhana, nationwide sample of males and females aged ≥15 years.
designThis was a cross-sectional secondary analysis of the 2022 GDHS. POPULATION: A representative sample of 22 058 individuals (females, 15 014 aged 15-49; males, 7044 aged 15-59) PRIMARY AND SECONDARY OUTCOME MEASURES: Current tobacco smoking, smokeless tobacco use and dual use.
resultsPrevalence for smoking, smokeless tobacco and dual use was 4.7 (4.1-5.4), 1.6 (1.3-2.0) and 0.6 (0.4-0.9) among males and 1.0 (0.8-1.3), 0.08 (0.05-0.1) and 0.1 (0.05-0.1) among females, respectively. Among males, smoking was associated with higher age (30-44 years: AOR: 2.3, 95% CI 1.7 to 3.1; 45-59 years: AOR: 2.6, 95% CI 1.8 to 3.7). Higher education was protective for both sexes [(males: AOR: 0.4, 95% CI 0.2 to 0.8) and (females: AOR: 0.4, 95% CI 0.2 to 0.8)] compared with their counterparts who had no education. Males in the Coastal zone had higher odds of use (AOR: 1.8, 95% CI 1.3 to 2.3) compared with males in the Middle zone, while females in the Northern/Savanna zone had lower odds of tobacco use (AOR: 0.5, 95% CI 0.3 to 0.8) compared with the Middle zone. Being Christian was associated with lower odds of smoking among males (AOR: 0.3, 95% CI 0.2 to 0.5) compared with others, while being Mole-Dagbani ethnic is associated with higher odds of smoking among females (AOR: 3.0, 95% CI 1.7 to 5.4).
conclusionThe study provides the first national analysis across Ghana's 16 regions and investigates patterns of smoking, smokeless tobacco and dual tobacco use. While tobacco use in Ghana remains predominantly smoked and male-driven, the divergent patterns of use across educational, regional and ethnic groups, especially the emerging risk among females, represent a significant public health shift that demands focused gender-sensitive tobacco control interventions.
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