| Summary: | Introduction
Using more than one tobacco product increases the risk of tobaccorelated
diseases. We investigated trends in the prevalence and dual use of
factory-made (FM) cigarettes, other tobacco products, and electronic cigarettes
(e-cigarettes) in South Africa over a 12-year period.
Methods
Data from five waves (2007, 2010, 2011, 2017, and 2018) of the South
African Social Attitudes Survey (n=14582) were analyzed. The use of FM,
roll-your-own (RYO) cigarettes, cigars, waterpipe, smokeless tobacco (SLT),
any combustible tobacco products (CTP), any tobacco product (ATP) use, and
e-cigarettes was investigated. The dual use of FM cigarettes with either SLT,
waterpipe or e-cigarettes was also explored. Chi-squared analyses and regression
models were used to explore trends in prevalence over the 12-year period.
Results
About 51% of the participants were female, and 51.9% were aged 16–34
years. CTP smoking significantly increased from 18.1% (2010) to 23.6% (2018)
(p=0.015), while ATPU increased from 20.2% (2010) to 25.9% (2018) (p=0.005).
Though dual use of FM cigarettes and SLT, waterpipe, or e-cigarettes was generally
low, the prevalence of dual use significantly increased for all product combinations
investigated: FM cigarettes and SLT (0.5% in 2007 to 1.3% in 2018, p=0.017), FM
cigarettes and waterpipe (0.9% in 2010 to 2.5% in 2018, p=0.014), FM cigarettes
and e-cigarettes (0.4% in 2010 to 1.8% in 2018, p<0.001). Compared to 2010, the
odds of the prevalence of CTP and ATP use significantly increased by 37% in 2018
(adjusted odds ratio, AOR=1.37; 95% CI: 1.06–1.77; p=0.018 and AOR=1.37; 95%
CI: 1.08–1.73; p=0.009, respectively) during the 12-year period after adjusting
for demographic characteristics.
Conclusions
The use and dual use of tobacco and electronic cigarette products
have been increasing in recent years in South Africa. Interventions to help users
quit and prevent young people from initiating use are urgently needed to curb
these increases.
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