Perceptions about the harmfulness of tobacco among adults in Uganda: Findings from the 2013 Global Adult Tobacco Survey

INTRODUCTION: Preferential option for some tobacco products over others might be attributed to inherent misconceptions about the harmfulness of tobacco. We analysed data from Uganda’s Global Adult Tobacco Survey (GATS) to assess misconceptions about the harmfulness of tobacco and associated factors. METHODS: Data were obtained from the 2013 Uganda Global Adult Tobacco Survey (GATS) of persons in Uganda of age ≥15 years among 8508 participants selected using a multi-stage sampling design to provide nationally representative estimates of the adult population. Participants were asked about perceptions of the harmfulness of smoking, using smokeless tobacco and whether all kinds of cigarettes are equally harmful. Weighted logistic regression analysis was used to find factors associated with the dependent variables. RESULTS: Among daily smokeless tobacco users, 98 (62%) were unaware that smokeless tobacco causes serious illness. Compared with participants without formal education, participants with primary education were less likely to be unaware that smoking causes serious illness (AOR=0.64, 95% CI: 0.48–0.84) as were participants with secondary education (AOR=0.28, 95% CI: 0.19–0.42) and participants with University education or higher (AOR=0.26, 95% CI: 0.11–0.58). Compared with participants who did not use any smokeless tobacco products, participants who used smokeless tobacco products less than daily were more likely to be unaware that smokeless tobacco causes serious illness (AOR=1.39, 95% CI: 0.54–3.61) as were participants who used smokeless tobacco products daily (AOR=5.87, 95% CI: 3.67–9.40). Compared with participants who did not use any smoked tobacco products, participants who used smoked tobacco products less than daily were more likely to believe that all cigarettes are equally harmful (AOR=2.40, 95% CI: 1.32–4.37) as were participants who used smoked tobacco products daily (AOR=3.08, 95% CI: 2.37–4.00). CONCLUSIONS: There is a high level of unawareness about the harmfulness of tobacco use particularly among tobacco users. The National Tobacco Control Program should prioritise public awareness and education about the dangers of tobacco use in the Tobacco Control Policy and National Tobacco Control Strategic Plan.