Changing patterns of tobacco consumption in Mozambique: evidence from a migrant study

BACKGROUND: Maputo, the Mozambique capital, contrasts with the rest of the country with regard to its sociodemographic characteristics and patterns of tobacco exposure. We conducted a migrant study to compare the prevalence of manufactured-cigarette smoking and traditional forms of tobacco use among dwellers in the capital who were also born in Maputo City (MC/MC) with those born in southern (SP/MC) and northern (NP/MC) provinces, and additionally with inhabitants in the latter regions. METHODS: In 2003, a representative sample of 12,902 Mozambicans aged 25-64 years was evaluated. We computed age- and education-adjusted prevalence ratios (PR) with 95%-confidence intervals (95%CI) using Poisson regression. RESULTS: The prevalence of any type of tobacco consumption among Maputo City inhabitants born in other provinces contrasted with the pattern observed in locally born inhabitants (SP/MC vs. MC/MC: men, PR, 0.61; 95%CI, 0.44-0.85; women, PR, 0.38, 95%CI, 0.18-0.79; NP/MC vs. MC/MC: men, PR, 0.66; 95%CI, 0.34-1.29; women, PR, 4.56, 95%CI, 1.78-11.69); the prevalence among city inhabitants born in other provinces resembled the pattern seen in inhabitants of their provinces of origin. Traditional forms of tobacco consumption among men were rare in Maputo City, which is in stark contrast to the situation in other provinces. CONCLUSIONS: Cultural background, affordability, and availability of different types of tobacco in urban Mozambique need to be considered when developing strategies to control the tobacco epidemic.