INTRODUCTION This study assessed the determinants of tobacco use among adults in Nigeria, exploring associations between different types of tobacco products and gender. METHODS Study data were derived from the 2013 Nigerian Demographic and Health Survey (NDHS). The NDHS is a nationally representative household survey of 39 902 women, 17 359 men and 38 522 households. Country weighted data were collected on participants' demographic characteristics and current tobacco use by type. Weighted prevalence estimates and 95% confidence intervals (CI) were performed to examine individual sociodemographic factors and tobacco use. A multivariate logistic regression was also performed to assess the relationship between tobacco use, adjusting for sociodemographic characteristics. RESULTS Overall prevalence of any tobacco use in 2013 was 2.9% (n=1621, 95% CI: 2.8-3.0). The prevalence of any tobacco use was 8.3% (95%CI: 7.8-8.8, p<0.001) in men and 0.4% (95%CI: 0.3-0.5, p<0.001) in women. Cigarettes and snuff were the most commonly used tobacco products in men and women. Dual (smoking and smokeless tobacco products) use was associated with increased odds among men (AOR=26.1, 95%CI: 11.7-58.5, p<0.001), aged 45-59 years (AOR=5.6, 95%CI: 2.1-15.2, p<0.01) and completely/semi-illiterate (AOR=1.8, 95CI: 1.1-2.9, p<0.05). CONCLUSIONS Men and women differed in their preference of type of tobacco product and the associated risk factors. Tobacco control policies need to take these specific differences into consideration for the design and implementation of interventions aimed at addressing tobacco use.
INTRODUCTIONTobacco use is the leading cause of preventable death and is responsible for about 6 million deaths each year worldwide 1,2 . The death toll is expected to rise to 8 million by 2030, if current trends continue 2 . Thus, urgent action to curb the consumption of tobacco products is imperative, particularly in developing countries were tobacco use is becoming alarmingly popular3. About 80% of the current 1.3 billion smokers live in low and middle income countries 4 . In 2010, annual tobacco-related deaths in low and middle income countries were estimated at 4.3 million, corresponding to about 25% more deaths than tuberculosis, malaria and HIV/AIDS 5 . The increasing prevalence of tobacco consumption in developing countries is associated with aggressive marketing strategies, employed by the tobacco industry, which explicitly target the youth and women 6,7 . Meanwhile, tobacco consumption, particularly cigarette smoking, is on the decline in many developed countries 1,8 , a result of successful anti-tobacco campaigns and national tobacco control policies. As a consequence, the tobacco industry has targeted new emerging markets, leading to tobacco consumption spreading across the globe 9,10 . The increase in tobacco use in developing AFFILIATION