Tobacco use in older adults in Ghana: sociodemographic characteristics, health risks and subjective wellbeing

BMC Public Health

Richard Biritwum⁶  Paul Kowal¹  Somnath Chatterji⁵  Nirmala Naidoo⁵  Nadia Minicuci⁷  George Mensah⁶  Phyllis Dako-Gyeke²  Sandra Hewlett⁴  Benedict Calys-Tagoe³  Nana Ayegua Hagan-Seneadza³  Akosua Baddoo³  Alfred E Yawson³ 

[1] University of Newcastle Research Centre on Gender, Health and Aging, Newcastle, Australia;Department of Social and Behavioral Sciences, School of Public Health, College of Health Sciences, University of Ghana, Legon, Accra, Ghana;Public Health Unit, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana;University of Ghana Dental School, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana;World Health Organization, Multi-Country Studies unit, Geneva, Switzerland;Department of Community Health, University of Ghana Medical School, College of Health Sciences, Room 46, P. O. Box 4236, Korle-Bu, Accra, Ghana;National Council Research, Institute of Neuroscience, Padova, Italy

关键词: Middle income countries;    Ghana;    Subjective wellbeing;    Tobacco use;    Older adults;   

Others  :  1161643
DOI  :  10.1186/1471-2458-13-979

 received in 2013-08-14, accepted in 2013-10-16,  发布年份 2013

【 摘 要 】

Background

Tobacco use over the life-course threatens to increase disease burden in older adulthood, including lower income countries like Ghana. This paper describes demographic, socioeconomic, health risks and life satisfaction indices related to tobacco use among older adults in Ghana.

Methods

This work was based on the World Health Organization’s multi-country Study on global AGEing and adult health (SAGE), conducted in six countries including Ghana. Wave one of SAGE in Ghana was conducted in 2007-2008 as collaboration between WHO and the University of Ghana Medical School through the Department of Community Health. A nationally representative sample of 4305 older adults aged 50 years and above were interviewed. Associations between tobacco consumption and sociodemographic, socioeconomic, health risk and life satisfaction were evaluated using chi-square and odds ratio (OR). Logistic regression analyses, adjusted for age, sex and other variables, were conducted to determine predictors of tobacco consumption in older persons.

Results

Overall prevalence of current daily smokers among older adults in Ghana was 7.6%. Tobacco use (i.e. ever used tobacco) was associated with older males, (AOR = 1.10, CI 1.05-1.15), older adults residing in rural locations (AOR = 1.37, CI 1.083-1.724), and older adults who used alcohol (AOR = 1.13, CI 0.230-2.418). Tobacco use was also associated (although not statistically significant per p-values) with increased self-reporting of angina, arthritis, asthma, chronic lung disease, depression, diabetes, hypertension, and stroke. Older adults who used tobacco and with increased health risks, tended to be without health insurance (AOR = 1.41, CI 1.111-1.787). Satisfaction with life and daily living was much lower for those who use tobacco. Regional differences existed in tobacco use; the three northern regions (Upper East, Northern and Upper West) had higher proportions of tobacco use among older adults in the country. Quitting tobacco use was higher in the 70+ years age group, in women, among urban residents and in those with at least secondary education. Quitting tobacco use also increased with increasing income levels.

Conclusions

Tobacco use among older adults in Ghana was associated with older men living in rural locations, chronic ill-health and reduced life satisfaction. A high proportion of older adults have stopped using tobacco, demonstrating the possibilities for effective public health interventions. Health risk reduction strategies through targeted anti-smoking health campaigns, improvement in access to health and social protection (such as health insurance) will reduce health risks among older persons who use tobacco.

【 授权许可】

   
2013 Yawson et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]The PLOS, Editors M: Addressing global disparities in the burden of non communicable diseases: call for papers. PLoS Med 2012, 9(12):e1001360. 10.1371/ journal.pmed.1001360
• [2]United Nations Population Division, DESA: World Population Prospects. New York: United Nations: The 2010 Revision; 2011.
• [3]World Health Organization: The World Health Report. Geneva: World Health Organization; 2002. [Reducing risks, promoting healthy life]
• [4]Bloom DE, Cafiero ET, Jane Llopis E, Abrahams Gessel S, Bloom LR, Fathima S: The Global Economic Burden of Non communicable Diseases. Geneva: World Economic Forum; 2011. www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf
• [5]Pole D, Ikeme AC, Pobee JO, Larbi E, Williams H, Blankson J: The Mamprobi Survey–a screening survey for cardiovascular disease and risk factors in Africa: methodology and validity. Bull World Health Organ 1979, 57:81-87.
• [6]Global Burden of Disease Study 2010. 2012. http://www.healthmetricsandevaluation.org/sites/default/files/country-profiles/GBD%20Country%20Report%20-%20Ghana.pdf webcite
• [7]National Cancer Institute (NCI): Smokeless tobacco and cancer [online]. 2013. from http://www.cancer.-gov/cancertopics/factsheet/Tobacco/smokeless webcite, 2011
• [8]National Cancer Institute (NCI) (2011b): Cigar smoking and cancer. 2011. from http://www.cancer.gov/cancertopics/factsheet/Tobacco/cigars webcite
• [9]Ghana Statistical Service (GSS): Ghana Health Service (GHS), and ICF Macro. Ghana Demographic and Health Survey 2008. Accra, Ghana: GSS, GHS, and ICF Macro; 2009.
• [10]Department of Community Health, University of Ghana Medical School: Ghana National Report on World Health Survey (WHS). Published by the Department of Community Health, University of Ghana Medical School in collaboration with WHO; 2003. http://www.who.int/healthinfo/survey/whsgha-ghana.pdf webcite
• [11]Public Health Bill 2011 of the Republic of Ghana. Accra, Ghana: Published by the Ghana Assembly Press; 2012. http://www.africatobaccocontrol.org/en/index.php/media-center/latest-news/272-ghana-parliament-passes-the-public-health-bill-with-tobacco-control-measures webcite
• [12]Kowal P, Chatterji S, Naidoo N, Biritwum R, Wu F, Lopez Ridaura R, Maximova T, Arokiasamy P, Phaswana-Mafuya N, Williams S, Snodgrass JJ, Minicuci N, D'Este C, Peltzer K, Boerma JT, the SAGE Collaborators: Data Resource Profile: The World Health Organization Study on global AGEing and adult health (SAGE). Int J Epidemiol 2012, 1-11. doi:10.1093/ije/dys210
• [13]Biritwum RB, Mensah G, Minicuci N, Yawson AE, Naidoo N, Chatterji S, Kowal P: Study on global AGEing and adult health in Ghana: Methodology and household characteristics in Wave 1. Glob Health Action 2013, 6:20096. http://dx.doi.org/10.3402/gha.v6i0.20096 webcite
• [14]National Health Insurance Authority of Ghana: Annual Report of the National Health Insurance Scheme of Ghana (2010). 2011.
• [15]World Health Organization. 2013. http://blogs.bmj.com/tc/2013/07/11/new-who-report-more-tobacco-advertising-bans-smoke-free-spaces-save-millions-of-lives/?q=w_tc_blog_sidetab webcite
• [16]Owusu-Dabo E, Lewis S, McNeill A, Gilmore A, Britton J: Smoking uptake and prevalence in Ghana. Tob Control 2009, 18:365-370. 10.1136/tc.2009.030635
• [17]Blazer DG, Wu L: Patterns of tobacco use and tobacco-related psychiatric morbidity and substance use among middle-aged and older adults in the United States. Ment Health Ment Health 2012, 16(3):296-304.
• [18]John RM, Mamudu HM, Liber AC: Socioeconomic implications of tobacco use in Ghana. Nicotine Tob Res 2012, 14(10):1205-12. 10.1093/ntr/nts013
• [19]Henley SJ, Thun MJ, Chao A, Calle EE: Association between exclusive pipe smoking and mortality from cancer and other diseases. J Natl Cancer Inst 2004, 96:853-861.
• [20]Wipfli H, Samet JM: Global economic and health benefits of tobacco control: Part 1. Clinical Pharmacol Ther 2009, 86:263-271.
• [21]Gibson P, Mcdonald V, Marks G: Asthma in older adults. Lancet 2010, 376:803-813.
• [22]Gooneratne N, Patel N, Cocoran A: Chronic obstructive pulmonary disease diagnosis and management in older adults. J Am Geriatr Soc 2010, 58:1153-1162.
• [23]Tice JA, Kanaya A, Hue T, Rubin S, Buist DSM, LaCroix A, Bauer DC: Risk factors for mortality in middle-aged women. Arch Intern Med 2006, 166:2469-2477.
• [24]Lacroix A, Omenn G: Older adults and smoking. Clin Geriatr Med 1992, 8:69-87.
• [25]Wannamethee SG, Shaper AG, Whincup PH, Walker M: Smoking cessation and the risk of stroke in middle-aged men. JAMA 1995, 274:155-160.
• [26]Salive M, Cornoni-Huntley J, Lacroix A, Ostfeld AM, Wallace RB, Hennekens CH: Public health briefs. Am J Public Health 1992, 82:1268-1271.
• [27]Ghana Statistical Service: Ghana Living Standards Survey Report of the Fifth Round (GLSS 5). Ghana Statistical Service. Published by Ghana Statistical Service; 2008.
• [28]Doku D, Raisamo S, Wiium N: The role of tobacco promoting and restraining factors in smoking intentions among Ghanaian youth. BMC Public Health 2012, 12:662. 10.1186/1471-2458-12-662 BioMed Central Full Text
• [29]Peltzer K, Phaswana Mafuya N: Fruit and vegetable intake and associated factors in older adults in South Africa. Glob Health Action 2012, 5:18668. http://dx.doi.org/10.3402/gha.v5i0.18668 webcite