Tobacco use remains high, with smokers starting at a young age

The prevalence of smoking in South Africa remains high compared to other countries, with an average of 8.5 cigarettes smoked per day by daily smokers.

The Department of Health released the 2021 Global Adult Tobacco Survey (GATS) South Africa report on Thursday, which contains this information.

Based on the most recent data from GATS, a sample from 7 245 households shows that the prevalence of tobacco use in South Africa is 29.4%.

The data also reveal that a higher percentage of men (41.7%) are currently using tobacco compared to women (17.9%).

Lead investigator, Dr Catherine Egbe from the South African Medical Research Council (SAMRC), stated that 21.2% of adults in South Africa smoke daily, while 4.6% smoke occasionally.

The Northern Cape has the highest prevalence of tobacco use, followed by the Western Cape. Limpopo, according to the report, has the lowest level of tobacco use.

Shifting her focus to the age of initiation of tobacco use, Egbe said the average age of initiation is 17.6 years old among adults aged between 20 and 34. 

The study shows that 20.9% of urban residents and 13.5% of rural residents initiated smoking before the age of 15. 

In addition, Egbe stated, 33.9% of daily tobacco users smoke within five minutes of waking up.

E-cigarettes and hookah pipes

According to the study, 2.2% of respondents said they were currently using e-cigarettes, of which 3.8% are men and 0.7% are women. 

The study found that 70.3% of those who use e-cigarettes cited enjoyment, 67.5% mentioned flavour, 45.1% believed it to be less harmful than tobacco, and 43.5% claimed that friends or family members who use e-cigarettes had influenced them.

The study also found that 3.1% of adults reported smoking hookah pipe or hubbly bubbly. 

“The mean age of initiation for those who have ever smoked water pipe was 21.1 years,” according to Egbe. 

For those aged between 15 and 24, the average age of initiation was 17.3 years old. 

Among adults currently smoking tobacco, 80.9% attempted to quit without assistance, 4.1% used pharmacotherapy, and 42.9% received advice to stop from their healthcare provider.

Data also show that 74.4% of adults who visited public places were exposed to second-hand smoke (SHS) at bars, taverns, shebeens or nightclubs. 

Meanwhile, 19.9% were exposed to SHS at school, 16% at tertiary institutions, and 11.3% in cafes. 

Data indicates that men spent slightly more on cigarettes (R273.20), while women spent about R207.20 every month. 

Government interventions

The Department of Health’s deputy director of general primary healthcare, Jeanette Hunter, has noted an increase in the use of hookah, e-cigarettes, and vapes, particularly among young people.

“Studies have highlighted health risks associated with the use of e-cigarettes and hookah pipes, hubbly bubbly or shisha, even though they are aggressively marketed as healthier tobacco alternatives,” Hunter said. 

She said scientists have provided enough evidence for countries to act and put measures in place to curb the use of these new-generation products.  

“It is for this reason that we, as a country, amended the existing Tobacco Product Control Act, Act 83 of 1993, to incorporate the control of the use of electronic delivery systems. This amendment bill is at the stage of going through parliamentary processes.” 

Hunter also raised concern about people who are starting to smoke at a younger age. 

“Disappointingly, it reveals that a small percentage, only 42.9% of smokers, were advised by a healthcare provider to quit smoking.”

Tobacco cessation programmes

The department, according to Hunter, has since identified the need to establish tobacco cessation programmes in primary healthcare facilities and that the feasibility of such programmes is being explored. 

She also highlighted the importance of the proposed ban on smoking in enclosed spaces after it was found that 44.5% of adults in South Africa are exposed to SHS. 

Meanwhile, as part of the recommendations, Egbe emphasised the importance of implementing tobacco taxes, smoke-free laws, graphic health warnings, and total bans on tobacco advertising and promotion to reduce smoking initiation, particularly among young people.

“Effective strategies to reduce tobacco use, including putting in place more comprehensive laws that are compliant with the WHO Framework Convention on Tobacco Control, should be implemented to protect more people from exposure to SHS and provide cessation services to help more people who smoke to quit,” Egbe said. 

In addition, Egbe believes that if parliament were to pass the Tobacco Products and Electronic Delivery Systems Control Bill of 2022, it would help reduce long-term tobacco use and the burden of tobacco-related diseases. –

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