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Comparisons of Social and Demographic Determinants of Tobacco Use in the Democratic Republic of the Congo
Brian Colwell
Texas A&M University College Station
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9338-2778
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Globalization and Health.
Background: Worldwide, tobacco use has caused over 100 million deaths in the twentieth century and is projected to cause death in up to one billion people in the twenty-first century. It is a leading cause of early death and disability in over 100 countries and accounts for over 11% of global deaths, disproportionately affecting low- and middle-income countries. The purpose of the study was to examine a variety of social determinants of tobacco use in the Democratic Republic of the Congo, including region, sex, ethnicity, education, literacy, wealth index and place of residence, to gain insights with regard to tobacco use among sub-national groups.
Methods: This project was a secondary data analysis of the 2013-2014 Demographics and Health Survey (DHS) for the Democratic Republic of the Congo. Logistic regressions predicting smoking, use of snuff and smoking cigars or natural tobacco as dichotomous variables were conducted. Independent variables included age, educational level, religion, rurality, literacy, wealth index, occupation and ethnicity.
Results: Tobacco use is highest among those with less education and low literacy. It was also highest among the working poor. Older age and living in larger cities were predictive of smoking, although the relationship between age and smoking was not linear. There was a strong linear effect for wealth. Being in a professional, technical or managerial position was highly protective against smoking while being engaged in services, skilled and unskilled manual labor, and the army had significantly greater odds of smoking.
Conclusions: Data indicate that tobacco use in the DRC, as is common in the developing world, is heavily concentrated in the working poor with lower educational status. Higher educational status is consistently predictive of avoiding tobacco use. Additionally, examining only national-level data to ascertain tobacco use levels and patterns may lead to mistaken conclusions that can lead to inefficient and ineffective allocation of resources aimed at controlling tobacco use.
Keywords
Tobacco, Smoking, Snuff, Democratic Republic of the Congo, Demographic and Health Survey
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On 15 Jun, 2020
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On 03 Jun, 2020
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Editorial decision: Minor Revision
On 02 Apr, 2020
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Received 24 Feb, 2020
Reviewer #1 agreed
On 13 Feb, 2020
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Invitations sent on 12 Feb, 2020
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On 29 Jan, 2020
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This preprint is under consideration at Globalization and Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Comparisons of Social and Demographic Determinants of Tobacco Use in the Democratic Republic of the Congo
Brian Colwell
Texas A&M University College Station
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9338-2778
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 09 Jun, 2020
Published
On 20 Jul, 2020
No community comments so far
Editorial decision: Accept
On 15 Jun, 2020
Editor assigned
On 04 Jun, 2020
Submission checks complete
On 03 Jun, 2020
Editor invited
On 03 Jun, 2020
No comments provided
Editorial decision: Minor Revision
On 02 Apr, 2020
Review #1 received
Received 24 Feb, 2020
Reviewer #1 agreed
On 13 Feb, 2020
Reviewers invited
Invitations sent on 12 Feb, 2020
Submission checks complete
On 29 Jan, 2020
Editor assigned
On 29 Jan, 2020
First submitted
On 28 Jan, 2020
Editor invited
On 28 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Globalization and Health.
Background: Worldwide, tobacco use has caused over 100 million deaths in the twentieth century and is projected to cause death in up to one billion people in the twenty-first century. It is a leading cause of early death and disability in over 100 countries and accounts for over 11% of global deaths, disproportionately affecting low- and middle-income countries. The purpose of the study was to examine a variety of social determinants of tobacco use in the Democratic Republic of the Congo, including region, sex, ethnicity, education, literacy, wealth index and place of residence, to gain insights with regard to tobacco use among sub-national groups.
Methods: This project was a secondary data analysis of the 2013-2014 Demographics and Health Survey (DHS) for the Democratic Republic of the Congo. Logistic regressions predicting smoking, use of snuff and smoking cigars or natural tobacco as dichotomous variables were conducted. Independent variables included age, educational level, religion, rurality, literacy, wealth index, occupation and ethnicity.
Results: Tobacco use is highest among those with less education and low literacy. It was also highest among the working poor. Older age and living in larger cities were predictive of smoking, although the relationship between age and smoking was not linear. There was a strong linear effect for wealth. Being in a professional, technical or managerial position was highly protective against smoking while being engaged in services, skilled and unskilled manual labor, and the army had significantly greater odds of smoking.
Conclusions: Data indicate that tobacco use in the DRC, as is common in the developing world, is heavily concentrated in the working poor with lower educational status. Higher educational status is consistently predictive of avoiding tobacco use. Additionally, examining only national-level data to ascertain tobacco use levels and patterns may lead to mistaken conclusions that can lead to inefficient and ineffective allocation of resources aimed at controlling tobacco use.
Figure 1