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. 2024 Apr 22;26(5):589-596.
doi: 10.1093/ntr/ntad239.

Non-cigarette Tobacco Use and Stroke Among West Africans: Evidence From the SIREN Study

Adekunle Gregory Fakunle  1   2 , Akinkunmi Paul Okekunle  1   3 , Osahon Jeffery Asowata  4 , Onoja Akpa  4   5 , Fred S Sarfo  6 , Albert Akpalu  7 , Kolawole Wahab  8 , Reginald Obiako  9 , Morenikeji Komolafe  10 , Lukman Owolabi  11 , Godwin O Osaigbovo  12 , Abiodun M Adeoye  1 , Hemant K Tiwari  13 , Ezinne O Uvere  1 , Joshua Akinyemi  4 , Carolyn Jenkins  14 , Oyedunni Arulogun  15 , Philip Ibinaiye  9 , Lambert T Appiah  6 , Temilade Bello  2 , Arti Singh  6 , Joseph Yaria  1 , Benedict Calys-Tagoe  16 , Godwin Ogbole  17 , Ijezie Chukwuonye  18 , Chidinma Melikam  9 , Philip Adebayo  19 , Yaw Mensah  20 , Oladimeji Adebayo  1   5 , Sunday Adeniyi  8 , Wisdom Oguike  9 , Arnett Donna  21 , Rufus Akinyemi  22   23   24 , Bruce Ovbiagele  25 , Mayowa Owolabi  1   24   26
Affiliations

Non-cigarette Tobacco Use and Stroke Among West Africans: Evidence From the SIREN Study

Adekunle Gregory Fakunle et al. Nicotine Tob Res. .

Abstract

Introduction: Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans.

Methods: A total of 7617 respondents (NCT users: 41 vs. non-NCT: 7576) from the Stroke Investigative Research and Educational Network (SIREN) study were included in the current analysis. NCT use was defined as self-reported use of smoked (cigars or piper) or smokeless (snuff or chewed) tobacco in the past year preceding stroke events. Stroke was defined based on clinical presentation and confirmed with a cranial computed tomography/magnetic resonance imaging. Multivariable-adjusted logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship of NCT with stroke at a two-sided p < .05.

Results: Out of the 41 (0.54%) who reported NCT use, 27 (65.9%) reported using smokeless NCT. NCT users were older than non-NCT users (62.8 ± 15.7 vs. 57.7 ± 14.8 years). Overall, NCT use was associated with first-ever stroke (OR: 2.08; 95% CI: 1.02, 4.23) in the entire sample. Notably, smokeless NCT use was independently associated with higher odds of stroke (OR: 2.74; 95% CI: 1.15, 6.54), but smoked NCT use (OR: 0.16; 95% CI: 0.02, 1.63) presented a statistically insignificant association after adjusting for hypertension and other covariates.

Conclusions: NCT use was associated with higher odds of stroke, and public health interventions targeting NCT use might be promising in reducing the burden of stroke among indigenous Africans.

Implications: A detailed understanding of the relationship between NCT use and stroke will likely inform well-articulated policy guidance and evidence-based recommendations for public health prevention and management of stroke on the African continent.

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Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Multivariate adjustment for the association of smokeless and smoked non-cigarette tobacco (NCT) use by odds of stroke.
See this image and copyright information in PMC

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