title: Tobacco consumption in Mozambique: use of distinct types of tobacco across urban and rural settings.
abstract: BACKGROUND
  Monitoring tobacco consumption patterns is essential to define and evaluate strategies to control the tobacco epidemic. We aimed to quantify the use of smoked (manufactured/hand-rolled cigarettes) and smokeless (snuff/chew) tobacco, according to sociodemographic characteristics, in adult Mozambicans.
  
  
  METHODS
  A national representative sample (n = 3,323) of subjects aged 25-64 years was evaluated in 2005 following the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS), which included the assessment of tobacco consumption with the quantification of each type of tobacco used daily. We computed prevalences, and age- and education-adjusted prevalence ratios (PRs), with 95% CIs.
  
  
  RESULTS
  Daily smoking was reported by 9.1% (95% CI = 5.0-13.1) of women (manufactured, 3.4%; hand-rolled, 5.6%) and 33.6% (95% CI = 29.3-38.0) of men (manufactured, 18.7%; hand-rolled, 14.8%). Daily manufactured cigarette smoking was significantly more frequent in men (urban: PR = 14.62, 95% CI = 7.59-28.55; rural: PR = 4.32, 95% CI = 2.42-7.71). Daily hand-rolled cigarette smoking was three- to fourfold more frequent among men and nearly 80% less frequent in urban areas, regardless of sex. The prevalence of daily smokeless tobacco use was 7.4% (95% CI = 4.6-10.2) in women (chew, 6.4%; snuff, 1.0%) and 3.4% (95% CI = 1.7-5.2) in men (chew, 1.6%; snuff, 1.8%). Daily smokeless tobacco consumption was significantly less frequent in urban areas only among men (PR = 0.05, 95% CI = 0.01-0.33).
  
  
  CONCLUSIONS
  Despite the relatively low levels of manufactured cigarette smoking, traditional forms of tobacco consumption are frequent, especially among women and in rural settings, showing the need for control measures to target specifically different patterns of consumption.
authors.affiliation: Institute of Public Health-University of Porto (ISPUP), Porto, Portugal.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Padrão
authors.forename: Albertino
authors.initials: A
authors.lastname: Damasceno
authors.forename: Carla
authors.initials: C
authors.lastname: Silva-Matos
authors.forename: Helena
authors.initials: H
authors.lastname: Carreira
authors.forename: Nuno
authors.initials: N
authors.lastname: Lunet
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009073:Mozambique / Q000453:epidemiology; D012424:Rural Population; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D062789:Tobacco Products / Q000706:statistics & numerical data; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data; D014505:Urban Population