# Tobacco Use Patterns and Associated Factors Among Youth in Kampala’s Informal Settlements: A Cross-Sectional Study in Bwaise

## TL;DR

This study examines tobacco use patterns and risk factors among youth in Bwaise, an informal settlement in Kampala, finding high rates of both daily smoking and smokeless tobacco use.

## Contribution

The study provides current data on tobacco use among youth in informal settlements in Uganda, a population often overlooked in national surveys.

## Key findings

- Daily tobacco smoking prevalence was 37.9%, with 'Kibanga' being the most common product.
- Smokeless tobacco use was reported by 16.4% of participants.
- Key risk factors included being male, aged 21–30, and low education levels.

## Abstract

Tobacco use among the youth in Uganda remains higher than general national estimates. To tackle this challenge, the Centre for Tobacco Control in Africa and the World Health Organization assert a need for current data and tobacco use monitoring with emphasis on most at-risk populations. In Uganda, routine monitoring is done through quinquennials; Uganda Demographic Health Survey, World Health Organisation stepwise surveys, Global Adult Tobacco Survey and Global Youth Tobacco Survey. Although recent assessments reported tobacco use among the general population, current data is scarce among the youth in informal settlements. We sought to assess the patterns of tobacco use and associated factors among the youth in informal settlements, with focus on daily tobacco smoking and smokeless tobacco use.

We used a cross-sectional study design. Secondary data which was collected between March 2021 and April 2021 among 422 youth aged 18–30 in Bwaise was used. We used STATA version 17.0 to analyse the data, and Modified Poisson regression with robust standard errors to assess for associations.

The daily smokers were 160/422 (37.9%) while the smokeless tobacco users were 69/422 (16.4%). ‘Kibanga’ was the most smoked product (145/160) daily. Being male (adj.PR=1.68 [95%CI=1.27–2.23]), aged 21–30 years (adj.PR=1.72 [95% CI=1.28–2.33]), below secondary education (adj.PR=0.69[95%CI=0.56–0.87]), from central Uganda (adj.PR=0.64[95%CI=0.46–0.89]), not knowing that smoking causes serious illness (adj.PR=1.5[95%CI=1.11–2.03]), heart attacks (adj.PR=1.49[95%CI=1.11–4.83]) and lung cancer (adj.PR=1.71[95%CI=1.25–2.35]) were significantly associated with daily tobacco smoking. Age 21–30 years (adj.PR=1.75 [95%CI=1.04–2.96]), not believing that smokeless tobacco causes heart attacks and serious illness (adj.PR=3.02 [95%CI=1.87–4.87]) were associated with smokeless tobacco use.

Daily tobacco smoking and smokeless tobacco use prevalence were both higher than the national estimates. Future policy interventions among among youth in informal settlements should target males, aged 21–30 years, of education level below secondary, originating from central Uganda, as well as address knowledge gaps on the dangers of tobacco use