# Tobacco smoking and biomarker profile among beverage industrial workers and their spouses in Rwanda: A cross-sectional study

## TL;DR

This study examines smoking habits and health markers among beverage industry workers and their spouses in Rwanda, finding links between smoking and cardiovascular risk, high uric acid, and older age.

## Contribution

The study identifies specific biomarker associations with smoking in a low-prevalence, low-income setting among industrial workers and their spouses.

## Key findings

- Smoking prevalence was 6.8% among the studied population.
- Elevated cardiovascular disease risk and high serum uric acid levels are strongly associated with smoking.
- Older age (50+ years) is a significant predictor of smoking behavior.

## Abstract

Globally, smoking leads to over 7 million preventable deaths annually, with higher rates in men (16%) than women (7%). Although smoking rates have declined in high-income countries, tobacco use in Rwanda remains relatively low, with 14% of men and 3% of women affected. The focus on beverage industry workers and their spouses is justified by their higher income levels and potential exposure to stressful occupational factors that are commonly associated with smoking. The study aimed to assess tobacco smoking prevalence and the biomarker profiles of beverage industrial workers and their spouses in Rwanda. This research employed a cross-sectional study design conducted in a beverage manufacturing industry in Rwanda. The study targeted 822 individuals, including beverage industry employees and their spouses, aged 30–75 years. An initial sample size of 384 was calculated using the Cochrane formula, which was adjusted to 440 to account for non-responses. Data collection was conducted from May to December 2018. Data analysis was conducted using SPSS version 22, with chi-square and logistic regression tests to assess tobacco use and other associated factors with a significance cutoff of p < 0.05 at 95% CI. The study controlled for confounders by increasing the sample size and using stratified and simple random sampling to ensure representativeness. Additionally, the multicollinearity test with VIF and selection of variables for multivariate analysis were ensured. The analysis reveals 6.8% were smokers and several key predictors of smoking behavior. Participants with elevated cardiovascular disease (CVD) risk (≥10%) have significantly higher odds of smoking, with an adjusted odds ratio of 2.95 (95% CI: 1.10-7.88), suggesting that CVD risk is a crucial factor in smoking behavior due to overlapping lifestyle risks. Additionally, high serum uric acid (SUA) levels (≥7 mg/dl) are strongly associated with smoking, with an adjusted odds ratio of 4.28 (95% CI: 1.14-11.87), indicating that elevated SUA levels are over four times more likely to be linked to smoking. Age is another significant predictor, with participants aged 50 years or older being nearly three times more likely to smoke compared to younger individuals, as shown by an adjusted odds ratio of 2.77 (95% CI: 1.13-6.80). Participants with hypertension or those treated for hypertension have lower adjusted odds ratio of 0.38 (95% CI: 0.10-1.45). The study’s findings could guide public health policymakers in designing workplace-based smoking cessation programs tailored to industry employees and their spouses. The study found that tobacco smoking is relatively low in this population, with elevated cardiovascular disease risk. Also, there are significant associations between tobacco smoking and elevated CVD risk, high SUA levels, and older age. Policymakers should implement targeted awareness campaigns and education programs addressing the specific risk factors identified.