conference of tobacco control school of economics, university of cape town 16-18 july 2014...
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CONFERENCE OF TOBACCO CONTROLSCHOOL OF ECONOMICS, UNIVERSITY OF
CAPE TOWN16-18 JULY 2014
Socio-economic determinants of tobacco use in the Southern African Customs Union
Linda Nyabongopresented by Corne van Walbeek
Background to the study
Determinants of smoking prevalence is fairly well understood in many (mainly developed) countries
Studies about smoking prevalence in Africa has lagged behind
Pampel (2008) investigated socio-economic determinants of smoking in many African countries, using a general, undifferentiated model
This study adds to the literature by looking at countries in a region with similar price and tax regimes
The data
Country Women in DHS
Women in final sample (age 15-49)
Men in DHS
Men in final sample
(age 15-49)
Lesotho (2009)
7624 (age 15-
49)
7621 3317 (age 15-
59)
2988
Namibia (2006-7)
9804 (age 15-
49)
9779 3915 (age 15-
49)
3899
Swaziland (2006-7)
4987 (age 15-
49)
4977 4156 (age 15-
49)
4149
South Africa (2008)
Not declared
6499 Not declared
4649
The descriptive statistics (an example of Lesotho)
Men (n = 2988) Women (n = 7621) n Weighted % n Weighted %
Age 15-19 838 27.8 1,840 23.4 20-24 631 21.1 1,555 20.4 25-29 462 15.4 1,203 16.3 30-34 370 13.2 960 12.9 35-39 282 9.7 755 10.0 40-44 204 6.5 663 8.6 45-49 201 6.4 645 8.4 Residence Rural 2313 71.9 5,646 66.3 Urban 675 28.1 1,975 33.7 Education No school 393 11.2 114 1.1 Primary 1494 48.8 3,863 46.6 Secondary 955 34.1 3,276 46.4 Post-Secondary 146 5.9 368 5.8 Occupation Not Working 936 31.8 4,285 54.9 Agriculture 1143 34.8 951 9.9 Service-Manual 662 24.2 1,367 21.2 Non-Manual 247 9.2 1,018 14.0 Religion Other 348 10.2 583 7.0 Catholic 1217 42.4 3,217 42.6 Protestant 11423 47.4 3,821 50.2
Tobacco use prevalence amongst males
Tobacco use prevalence amongst females
Cigarette smoking prevalence by males by age
Pipe smoking prevalence amongst males by age
Cigarette smoking prevalence by females by age
Snuff use prevalence by females by age
Cigarette smoking prevalence by education, males
Pipe smoking prevalence by education, males
Cigarette smoking prevalence by education, females
Snuff use prevalence by education, females
The empirical model
Logistic regressionResults are presented in the form of odds
ratios Odds ratio > 1: more likely to consume tobacco than
base category Odds ratio < 1: less likely to consume tobacco than
base category P(Tob = 1) = f(Age, Residence, Education,
Occupation, Religion)
Example of regression output
Another example: females in Namibia
Combined regression output for cigarettes, males
Combined regression output for cigarettes, females
Summary of main findings
Cigarette smoking more likely in the urban areas amongst females
Pipe smoking, chewing tobacco and snuff more concentrated in rural areas for both males and females
Generally, as education increases, prevalence of tobacco use decreases Exceptions: cigarette smoking among females
No clear relationship between occupation and smoking prevalence
Limitations of the study
Age restricted to 15-49
Price not included in the analysis
Ethnicity not asked in DHS (although this is only really relevant in Namibia)
Implications and conclusion
Negative relationship between SES and prevalence of tobacco use
Many studies (not this one) have shown that people with lower SES are more price responsive
An increase in the price of tobacco products will be more effective in reducing tobacco use amongst people with lower SES and will thus decrease inequalities in tobacco use