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. 2023 Jul 17:21:94.
doi: 10.18332/tid/168121. eCollection 2023.

Trends in the use and dual use of factory-made combustible cigarettes, other tobacco products and electronic cigarettes: Results from South African Social Attitudes Surveys during 2007 to 2018

Catherine O Egbe  1   2 , Siphesihle Gwambe  1 , Mukhethwa Londani  1   3 , Olufemi Erinoso  4 , Olalekan A Ayo-Yusuf  5
Affiliations

Trends in the use and dual use of factory-made combustible cigarettes, other tobacco products and electronic cigarettes: Results from South African Social Attitudes Surveys during 2007 to 2018

Catherine O Egbe et al. Tob Induc Dis. .

Abstract

Introduction: Using more than one tobacco product increases the risk of tobacco-related diseases. We investigated trends in the prevalence and dual use of factory-made (FM) cigarettes, other tobacco products, and electronic cigarettes (e-cigarettes) in South Africa over a 12-year period.

Methods: Data from five waves (2007, 2010, 2011, 2017, and 2018) of the South African Social Attitudes Survey (n=14582) were analyzed. The use of FM, roll-your-own (RYO) cigarettes, cigars, waterpipe, smokeless tobacco (SLT), any combustible tobacco products (CTP), any tobacco product (ATP) use, and e-cigarettes was investigated. The dual use of FM cigarettes with either SLT, waterpipe or e-cigarettes was also explored. Chi-squared analyses and regression models were used to explore trends in prevalence over the 12-year period.

Results: About 51% of the participants were female, and 51.9% were aged 16-34 years. CTP smoking significantly increased from 18.1% (2010) to 23.6% (2018) (p=0.015), while ATPU increased from 20.2% (2010) to 25.9% (2018) (p=0.005). Though dual use of FM cigarettes and SLT, waterpipe, or e-cigarettes was generally low, the prevalence of dual use significantly increased for all product combinations investigated: FM cigarettes and SLT (0.5% in 2007 to 1.3% in 2018, p=0.017), FM cigarettes and waterpipe (0.9% in 2010 to 2.5% in 2018, p=0.014), FM cigarettes and e-cigarettes (0.4% in 2010 to 1.8% in 2018, p<0.001). Compared to 2010, the odds of the prevalence of CTP and ATP use significantly increased by 37% in 2018 (adjusted odds ratio, AOR=1.37; 95% CI: 1.06-1.77; p=0.018 and AOR=1.37; 95% CI: 1.08-1.73; p=0.009, respectively) during the 12-year period after adjusting for demographic characteristics.

Conclusions: The use and dual use of tobacco and electronic cigarette products have been increasing in recent years in South Africa. Interventions to help users quit and prevent young people from initiating use are urgently needed to curb these increases.

Keywords: South Africa; combustible tobacco; dual product use; e-cigarettes; tobacco use.

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Conflict of interest statement

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors declare that they have no competing interests, financial or otherwise, related to the current work. C.O. Egbe, S. Gwambe and M. Londani report that since the initial planning of the work they received support, 50% of APC, from South African Medical Research Council. C.O. Egbe reports that in the past 36 months, he received support for attending meetings or travel from South African Medical Research Council. O.A. Ayo-Yusuf reports that since the initial planning of the work he received support, 50% of APC, from University of Pretoria. Also, he reports that in the past 36 months he received a grant from Africa Capacity Building Foundation (Grant no. 326).

Figures

Figure 1
Figure 1
Trends in dual use by tobacco/nicotine product types between 2007 to 2018 in South Africa
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