A systematic literature review of tobacco use among adults 15 years and older in sub-Saharan Africa.
BACKGROUND
Given that developing countries (and particularly women in these countries) are at increasing risk for tobacco use, the need for hard data to accurately monitor tobacco use in developing countries is needed. The purpose of this review is to synthesize the available prevalence data on current tobacco use among adults in sub-Saharan Africa (SSA).


METHODS
Several databases were systematically searched for articles published in peer-reviewed journals at any time during the last century to mid-2005. The search resulted in the retrieval of 54 articles in which the current use of tobacco, cigarettes, cigars and snuff were reported. They were conducted in 14 of the 48 SSA countries.


RESULTS
Cross-country comparisons revealed that the prevalence, and intensity (frequency and/or quantity) of tobacco use was higher among males compared to females across all countries. Certain racially classified social groups in South Africa were at increased risk for tobacco use. Males aged between 30 and 49 years used tobacco at higher rates than those younger or older than this age range. Among females, prevalence rates of smoked tobacco use increased steadily with age. There was no clear pattern regarding socio-economic status (SES) or urban/rural differences. The onset of tobacco use mostly occurs in late adolescence or early adulthood.


CONCLUSIONS
While in many SSA countries the prevalence of tobacco use among adults is relatively low compared to developed and other developing countries, prevention, interventions and policies should work towards reducing these levels by targeting the at risk populations identified from this review.
Townsend
Loraine
L
Department of Psychiatry and Mental Health and Adolescent Health Research Institute, University of Cape Town, E36A Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa. townsend@curie.uct.ac.za
Flisher
Alan J
AJ
Gilreath
Tamika
T
King
Gary
G
D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000367:Age Factors; D002391:Catchment Area, Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014029:Tobacco Use Disorder / Q000453:epidemiology*; D014505:Urban Population / Q000706:statistics & numerical data