Socioeconomic inequalities in cigarette smoking among men: evidence from the 2003 and 2008 Ghana demographic and health surveys

BACKGROUND: Tobacco use is a public health burden in both developed and developing countries. However, there is still a dearth of nationally representative studies from Sub-Saharan Africa to inform interventions in the region. Socioeconomic trends and disparities in cigarette smoking were explored among Ghanaian men. METHOD: A nationally representative sample of Ghanaian men 15–59 years was surveyed in the 2003 (N = 5015) and 2008 (N = 4568) Ghana Demographic and Health Surveys (N = 9583). Logistic regression analyses were conducted to investigate cigarette smoking by socioeconomic status (SES) and the changes over the two study periods. The results are presented as adjusted odds ratios (AOR) at 95% confidence intervals (CI) RESULTS: The prevalence decreased by 1.7% from 9% (95% CI 0.09–0.11) in 2003 to 7.3% (95% CI 0.07–0.09) in 2008. The prevalence of cigarette smoking was higher in the older age groups (25–34 year-olds and 35–59 year-olds) compared to 15–24 year-olds. Education (AOR = 2.2, 95% CI 1.4–3.4; no education vs higher education) and occupation (AOR = 4.2, 95% CI 2.3–7.6; not working vs managerial position) and being in labour force (AOR = 2.6, 95% CI 1.7–4.0) were related to cigarette smoking. Furthermore, religion, wealth (AOR = 3.1 95% CI 2.1–4.5; poorest compared to richest) and rural residence (AOR = 1.8, 95% CI 1.5–2.1) were associated with cigarette smoking. Over the period, cigarette smoking seems to have decreased among Ghanaian male at the population level but not among all groups by age, education, wealth and place of residence. CONCLUSION: Cigarette smoking interventions should be structured to reduce the menace among men. Such interventions must also particularly target lower socioeconomic groups in order to avert an increase in the inequalities in the behaviour and prervent a consequent increase in the socioeconomic gradient in tobacco-related diseases and deaths.